2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines

Arnett, Donna K.; Blumenthal, Roger S.; Albert, Michelle A.; Buroker, Andrew B.; Goldberger, Zachary D.; Hahn, Ellen J.; Himmelfarb, Cheryl Dennison; Khera, Amit; Lloyd‐Jones, Donald M.; McEvoy, John W.; Michos, Erin D.; Miedema, Michael D.; Muñoz, Daniel; Smith, Sidney C.; Virani, Salim S.; Williams, Kim A.; Yeboah, Joseph; Ziaeian, Boback

doi:10.1161/cir.0000000000000677

Cited by 2,148 publications

(950 citation statements)

References 277 publications

Supporting

Mentioning

903

Contrasting

Unclassified

Order By: Relevance

“…72 Based on recent evidence, US primary prevention guidelines have provided a prudent recommendation regarding aspirin for primary prevention. 73 Generally, aspirin (75-100 mg daily) is only indicated at those hypertensive patients with established CVD for secondary prevention, or those at 40-70 years with higher CVD risk but not at increased risk of bleeding in the primary prevention setting.…”

Section: Manag Ement Of a Sso Ciated C Vd Ris K Fac Tor Smentioning

confidence: 99%

Expert consensus on the management of hypertension in the young and middle‐aged Chinese population

Liu

Chen

et al. 2019

Int J Clin Pract

View full text Add to dashboard Cite

Summary Background and purposeThe increased prevalence of hypertension, along with obesity, dyslipidemia, and type 2 diabetes in the young and middle‐aged population has become a major global public health issue. Although more attention has been paid to the management of hypertension and cardiovascular disease (CVD) risks in elderly patients nationally and internationally, there is currently no consensus worldwide on appropriate evaluation and treatment of hypertension in younger subjects. We developed the consensus and aimed to provide a comprehensive strategy for the management of hypertension in young and middle‐aged population. MethodsThe authors and experts of the Hypertension Group of the 10th committee of Chinese Society of Cardiology reviewed the available literature and evidence on the pathophysiological characteristics of hypertension, CVD risk assessments and antihypertensive therapies, discussed and reached an agreement on recommendations. Disccussions and recommendationsThe pathophysiological and clinical characteristics of hypertension in young and middle‐aged patients are vastly different from those observed in the elderly. In particular, the sympathetic nervous system (SNS) and the renin‐angiotensin system (RAS) are significantly activated in this population. Global CVD risk assessment should be performed as determinants of initiating anti‐hypertensive therapy. A blood pressure (BP) target of <140/90 mm Hg should be achieved first on BP‐lowering therapies, with an ultimate BP <130/80 mm Hg for most patients, if tolerated. Initiating BP‐lowering therapies with a beta‐blocker or RAS inhibitor (angiotensin‐converting enzyme inhibitor or angiotensin II receptor blocker), or in combination with calcium channel blocker or diuretic in high CVD risk patients, along with active lifestyle changes, are preferred. ConclusionsAn aggressive and comprehensive BP and CVD risk management strategy should be implemented in the young and middle‐aged hypertensive population.

show abstract

Section: Manag Ement Of a Sso Ciated C Vd Ris K Fac Tor Smentioning

confidence: 99%

Expert consensus on the management of hypertension in the young and middle‐aged Chinese population

Liu

Chen

et al. 2019

Int J Clin Pract

View full text Add to dashboard Cite

show abstract

“…College of Cardiology/American Heart Association Guideline on thePrimary Prevention of Cardiovascular Disease; indeed, it is stated that "for adults with type 2 diabetes and additional ASCVD risk factors it may be reasonable to initiate a SGLT-2i or a GLP-1RA to improve glycaemic control and reduce CVD risk (class IIB). "43 8 | CONCLUSIONSAll the accumulated evidence(Table 3)suggests that SGLT-2is should be considered for control of hyperglycaemia in T2D patients, particularly in those with established CVD, given that they reduce the risk of MACE, hospitalization for HF and progression of DKD. The remarkable reduction in risk of HF seen across CVOTs and observational data,44 is one major benefit of SGLT-2 inhibition therapy.…”

mentioning

confidence: 99%

Primary versus secondary cardiorenal prevention in type 2 diabetes: Which newer anti‐hyperglycaemic drug matters?

Giugliano

Ceriello

Nicola

et al. 2019

Diabetes Obesity Metabolism

View full text Add to dashboard Cite

We are observing a resurgence of major diabetic vascular complications after a period of dramatic decrease during the period 1990 to 2010. The classical division of cardiovascular prevention into primary (with an event) and secondary (without an event) is largely used to describe cardiovascular risk in type 2 diabetes (T2D); however, there is evidence that the cardiovascular risk in diabetes may range from highest in patients who experienced a previous cardiovascular event to mild in patients with the main risk factors at target. Herein, we present details of the 14 cardiovascular outcome trials (CVOTs) published to date, including the total population investigated, and their separation into primary (T2D + multiple risk factors) and secondary prevention (T2D + established cardiovascular disease [CVD]) populations as detailed within the trials. We also summarize evidence for the effects of dipeptidyl peptidase‐4 inhibitors (DPP‐4i), glucagon‐like peptide‐1 receptor agonists (GLP1‐RA) and sodium glucose co‐transporter‐2 inhibitors (SGLT‐2i) versus placebo on the risk of major cardiovascular events (MACE), heart failure (HF) and diabetic kidney disease (DKD). In primary prevention, SGLT‐2i reduce both the risk of hospitalization for HF and progression of DKD; in secondary prevention, SGLT‐2i are effective on the three endpoints, DPP‐4i are neutral, while GLP1‐RA show mixed results.

show abstract

“…Although statins are beneficial in preventing ASCVD [3,4], residual risk after statin treatment should be considered in specific conditions [5,6,12,[21][22][23][24][25][26]. In T2DM, possible candidates for residual risks include sdLDL [12], postprandial hypertriglyceridemia [25], and TG-rich lipoproteins [21,25,26].…”

Section: Discussionmentioning

confidence: 99%

“…To prevent atherosclerotic cardiovascular disease (ASCVD) in type-2 diabetes mellitus (T2DM), controlling low-density lipoprotein cholesterol (LDL-C) levels is crucial [1,2]. HMG-CoA reductase inhibitors (statins) are widely used to target recommended levels of LDL-C in T2DM [3,4]. However, at a certain rate, LDL-C target levels are difficult to reach, largely due to statin ineffectiveness and/or intolerance, which limit the potential ASCVD risk reduction of statin treatment [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Dissimilar Effects of Anagliptin and Sitagliptin on Lipoprotein Subclass in Standard or Strong Statin-Treated Patients with Type-2 Diabetes Mellitus: A Subanalysis of the REASON (Randomized Evaluation of Anagliptin versus Sitagliptin on Low-Density LipoproteiN Cholesterol in Diabetes) Trial

Hikita

Higa

Morimoto

et al. 2019

JCM

View full text Add to dashboard Cite

The effects of antidiabetic agents on lipoprotein subclasses are assumed to be pivotal, but this assumption has not been studied. We evaluated lipoprotein subclasses in patients, randomly selected from REASON (Randomized Evaluation of Anagliptin versus Sitagliptin On low-density lipoproteiN cholesterol in diabetes) Trial participants, with type-2 diabetes treated with either anagliptin or sitagliptin. We measured total cholesterol (TC) and triglycerides (TG) in 4 (chylomicron (CM), very low-density lipoprotein (VLDL), low density lipoprotein (LDL), and high-density lipoprotein (HDL)) lipoprotein classes and 20 (2 CM, 5 VLDL, 6 LDL, and 7 HDL) lipoprotein subclasses. Between 0 and 52 weeks, TC and TG in lipoprotein and the lipoprotein subclass were distributed differently in patients treated with anagliptin and sitagliptin. The preferable changes in TC and TG levels were observed dominantly in the anagliptin-treated group under standard statin therapy, but the benefits were observed in both the anagliptin- and sitagliptin-treated groups, at least partially under strong statin therapy. In future studies, the atherogenic properties of lipoprotein subclasses might be considered when employing antidiabetic dipeptidyl peptidase-4 (DPP-4) inhibitors, especially in patients with type-2 diabetes who are at risk of atherosclerotic cardiovascular disease (ASCVD) or are undergoing statin treatment.

show abstract

2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines

Cited by 2,148 publications

References 277 publications

Expert consensus on the management of hypertension in the young and middle‐aged Chinese population

Expert consensus on the management of hypertension in the young and middle‐aged Chinese population

Primary versus secondary cardiorenal prevention in type 2 diabetes: Which newer anti‐hyperglycaemic drug matters?

Dissimilar Effects of Anagliptin and Sitagliptin on Lipoprotein Subclass in Standard or Strong Statin-Treated Patients with Type-2 Diabetes Mellitus: A Subanalysis of the REASON (Randomized Evaluation of Anagliptin versus Sitagliptin on Low-Density LipoproteiN Cholesterol in Diabetes) Trial

Contact Info

Product

Resources

About