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Medicine by the numbers

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Syncope: Evaluation and Differential Diagnosis - American Family Physician

Mar 1, 2017 - Syncope is an abrupt and transient loss of consciousness caused by cerebral hypoperfusion. It accounts for 1% to 1.5% of emergency department visits, resulting in high hospital admission rates and significant medical costs. Syncope is classified as neurally mediated, cardiac, and ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0301/p303.html

Palpitations: Evaluation in the Primary Care Setting - American Family Physician

Dec 15, 2017 - Palpitations are a common problem in the ambulatory primary care setting, and cardiac causes are the most concerning etiology. Psychiatric illness, adverse effects of prescription and over-the-counter medications, and substance use should also be considered. Distinguishing cardiac from ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1215/p784.html

Heart Failure with Preserved Ejection Fraction: Diagnosis and Management - American ...

Nov 1, 2017 - Heart failure with preserved ejection fraction, also referred to as diastolic heart failure, causes almost one-half of the 5 million cases of heart failure in the United States. It is more common among older patients and women, and results from abnormalities of active ventricular ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1101/p582.html

Stable Coronary Artery Disease: Treatment - American Family Physician

Mar 15, 2018 - Stable coronary artery disease refers to a reversible supply/demand mismatch related to ischemia, a history of myocardial infarction, or the presence of plaque documented by catheterization or computed tomography angiography. Patients are considered stable if they are asymptomatic or ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0315/p376.html

Venous Ulcers: Diagnosis and Treatment - American Family Physician

Sep 1, 2019 - Venous ulcers are the most common type of chronic lower extremity ulcers, affecting 1% to 3% of the U.S. population. Venous hypertension as a result of venous reflux (incompetence) or obstruction is thought to be the primary underlying mechanism for venous ulcer formation. Risk factors ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0901/p298.html

Diagnosis and Management of Common Types of Supraventricular Tachycardia - American ...

Nov 1, 2015 - Supraventricular tachycardia refers to rapid rhythms that originate and are sustained in atrial or atrioventricular node tissue above the bundle of His. The condition is caused by reentry phenomena or automaticity at or above the atrioventricular node, and includes atrioventricular ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1101/p793.html

Coronary Artery Disease/Coronary Heart Disease - American Family Physician

Jun 1, 2020 - This collection features AFP content on coronary artery disease (CAD), coronary heart disease (CHD) and related issues, including acute coronary syndrome, angina, cardiomyopathy, hypertension, and myocardial infarction. This collection features AFP content on coronary artery disease ...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=4

Acute Coronary Syndrome: Diagnostic Evaluation - American Family Physician

Feb 1, 2017 - Myocardial infarction (MI), a subset of acute coronary syndrome, is damage to the cardiac muscle as evidenced by elevated cardiac troponin levels in the setting of acute ischemia. Coronary artery disease is the leading cause of mortality in the United States. Chest pain is a common ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0201/p170.html

Hyperlipidemia: Drugs for Cardiovascular Risk Reduction in Adults - American Family ...

Jan 15, 2017 - Guidelines from the American College of Cardiology/American Heart Association (ACC/AHA) and the U.K. National Institute for Health and Care Excellence (NICE) indicate that lipid-lowering drugs have benefit for primary and secondary prevention of atherosclerotic cardiovascular disease ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0115/p78.html

Lower Extremity Peripheral Artery Disease: Diagnosis and Treatment - American Family ...

Mar 15, 2019 - Lower extremity peripheral artery disease (PAD) affects 12% to 20% of Americans 60 years and older. The most significant risk factors for PAD are hyperlipidemia, hypertension, diabetes mellitus, chronic kidney disease, and smoking; the presence of three or more factors confers a 10-fold...

American Family Physician : Article

https://www.aafp.org/afp/2019/0315/p362.html

Diagnosis and Treatment of Atrial Fibrillation - American Family Physician

Sep 15, 2016 - Atrial fibrillation is a supraventricular arrhythmia that adversely affects cardiac function and increases the risk of stroke. It is the most common arrhythmia and a major source of morbidity and mortality; its prevalence increases with age. Pulse rate is sensitive, but not specific, ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0915/p442.html

Ticagrelor Compared to Clopidogrel in Acute Coronary Syndrome and Stable Coronary ...

Nov 1, 2019 - The authors determined there is no benefit from the use of ticagrelor in patients with acute coronary syndrome and stable coronary artery disease because of the uncertainty about benefits and evidence of potential harms.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2019/1101/od1.html

Dyspnea Due to Acute Heart Failure Syndrome - Medicine by the Numbers - American Family...

Feb 1, 2019 - This review concluded that the individual components of the clinical history and physical examination, electrocardiography, and chest radiography are not useful independently for confirming or excluding the diagnosis of acute heart failure syndrome in patients presenting to the ...

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2019/0201/od1.html

Heart Failure - American Family Physician

Feb 15, 2020 - This collection features AFP content on heart failure and related issues, including angiotensin-converting enzyme (ACE) inhibitors, angiotensin-receptor blockers (ARBs), cardiomyopathy, cardioverter-defibrillators, congestive heart failure, and diastolic and systolic heart failure. This...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=26

Myocardial Infarction: Management of the Subacute Period - American Family Physician

Nov 1, 2013 - Optimal management of myocardial infarction in the subacute period focuses on improving the discharge planning process, implementing therapies early to prevent recurrent myocardial infarction, and avoiding hospital readmission. Evidence-based guidelines for the care of patients with ...

American Family Physician : Article

https://www.aafp.org/afp/2013/1101/p581.html

Aortic Stenosis: Diagnosis and Treatment - American Family Physician

Mar 1, 2016 - Aortic stenosis affects 3% of persons older than 65 years. Although survival in asymptomatic patients is comparable to that in age- and sex-matched control patients, it decreases rapidly after symptoms appear. During the asymptomatic latent period, left ventricular hypertrophy and ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0301/p371.html

Statins in Persons at Low Risk of Cardiovascular Disease - Medicine by the Numbers - ...

Nov 1, 2017 - Despite the small reductions in nonfatal heart attacks and strokes, statins were not associated with a reduction in serious illness overall.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2017/1101/od1.html

Omega-3 Fatty Acids and Cardiovascular Disease Prevention - Medicine by the Numbers - ...

Aug 15, 2019 - High-quality evidence suggests that long-chain omega-3 polyunsaturated fatty acids do not prevent mortality (all-cause or cardiovascular) or cardiovascular disease events when used as primary or secondary prevention. Find out more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2019/0815/p209.html

Early Invasive Management of Acute Coronary Syndromes - Medicine by the Numbers - ...

Dec 1, 2018 - Does early invasive management help patients with unstable angina or acute non–ST-segment elevation myocardial infarction (NSTEMI) in reducing occurence of death, myocardial infarction, angina symptoms, and rehospitalization at six- to 12-month follow-up? Find out.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2018/1201/od1.html

Hormone Therapy for Primary Prevention of Cardiovascular Disease in Postmenopausal ...

Oct 1, 2018 - No benefit was observed in postmenopausal women receiving hormone therapy for primary prevention of cardiovascular disease. Find out more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2018/1001/od1.html

Diet and Physical Activity for Cardiovascular Disease Prevention - American Family ...

Jun 1, 2016 - Cardiovascular disease (CVD) is the leading cause of death in the United States. One-third of these deaths may be preventable through healthy lifestyle choices including diet and physical activity. The Mediterranean diet is associated with reduced cardiovascular mortality, whereas the ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0601/p919.html

Cardiac Rehabilitation: Improving Function and Reducing Risk - American Family Physician

Jul 1, 2016 - Cardiac rehabilitation is a comprehensive multidisciplinary program individually tailored to the needs of patients with cardiovascular disease. The overall goals focus on improving daily function and reducing cardiovascular risk factors. Cardiac rehabilitation includes interventions ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0701/p37.html

Beta Blockers Compared with Other Drug Options for the Treatment of Hypertension - ...

Feb 1, 2018 - Although beta blockers seem to have a positive impact on patient-oriented evidence that matters in patients with hypertension, they appear to be inferior when compared with other medications.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2018/0201/od1.html

Atrial Fibrillation - American Family Physician

Jun 15, 2020 - This collection features AFP content on atrial fibrillation and related issues, including anticoagulation therapy, antiplatelet therapy, arrhythmias, and palpitations. This collection features AFP content on atrial fibrillation and related issues, including anticoagulation therapy, ...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=33

Heart Failure Due to Reduced Ejection Fraction: Medical Management - American Family ...

Jan 1, 2017 - Heart failure is an increasingly common condition resulting in high rates of morbidity and mortality. For patients who have heart failure and reduced ejection fraction, randomized clinical trials demonstrate consistent mortality benefit from angiotensin-converting enzyme inhibitors, ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0101/p13.html

Stents for Stable Coronary Artery Disease - Medicine by the Numbers - American Family ...

Jan 1, 2018 - Most published trials fail to show a benefit from coronary stenting in patients with stable obstructive coronary artery disease. However, stent technology has evolved significantly in recent years, and it is possible that newer-generation drug-eluting stents may offer different results.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2018/0101/od1.html

Sick Sinus Syndrome: A Review - American Family Physician

May 15, 2013 - Sick sinus syndrome refers to a collection of disorders marked by the heart’s inability to perform its pacemaking function. Predominantly affecting older adults, sick sinus syndrome comprises various arrhythmias, including bradyarrhythmias with or without accompanying tachyarrhythmias. ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0515/p691.html

Nutrition Myths and Healthy Dietary Advice in Clinical Practice - American Family ...

May 1, 2015 - Healthy dietary intake is important for the maintenance of general health and wellness, the prevention of chronic illness, the optimization of life expectancy, and the clinical management of virtually all disease states. Dietary myths (i.e., concepts about nutrition that are poorly ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0501/p634.html

Prolonged Dual Antiplatelet Therapy After MI Reduces Major Adverse Cardiac Events - ...

Oct 1, 2017 - In patients who are stable one year post-MI, prolonged use of dual antiplatelet therapy may be an effective treatment to decrease major cardiac events and cardiovascular mortality.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2017/1001/od1.html

Rivaroxaban vs. Warfarin for Anticoagulation in Patients with Atrial Fibrillation ...

Oct 1, 2016 - Studies showed that 433 patients needed to be treated with rivaroxaban to prevent one stroke and 629 patients needed to be treated with rivaroxaban to prevent one thromboembolic event. Read more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2016/1001/od1.html

Diagnosis and Treatment of Peripheral Arterial Disease - American Family Physician

Sep 1, 2013 - Peripheral arterial disease (PAD) is atherosclerosis leading to narrowing of the major arteries distal to the aortic arch. The most common presenting symptom is claudication; however, only 10% of patients have classic claudication. Approximately 8 to 12 million Americans have PAD, ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0901/p306.html

Common Questions About Pacemakers - American Family Physician

Feb 15, 2014 - Pacemakers are indicated in patients with certain symptomatic bradyarrhythmias caused by sinus node dysfunction, and in those with frequent, prolonged sinus pauses. Patients with third-degree or complete atrioventricular (AV) block benefit from pacemaker placement, as do those with type...

American Family Physician : Article

https://www.aafp.org/afp/2014/0215/p279.html

Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: ...

Jan 15, 2017 - The USPSTF recommends that adults without a history of cardiovascular disease (CVD) (i.e., symptomatic coronary artery disease or ischemic stroke) use a low- to moderate-dose statin for the prevention of CVD events and mortality when all of the following criteria are met: (1) they are ...

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2017/0115/od1.html

The Case Against Coronary Artery Calcium Scoring for Cardiovascular Disease Risk ...

Dec 15, 2019 - Although coronary artery calcium testing may slightly improve future risk prediction, this theoretical benefit is outweighed by its potential harms.

American Family Physician : Editorials

https://www.aafp.org/afp/2019/1215/p734.html

Applying a Clinical Decision Rule for CAD in Primary Care to Select a Diagnostic Test ...

May 1, 2019 - Using the INTERCHEST chest pain decision rule to decide next steps when a patient presents to a primary care physician with chest pain.

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2019/0501/p584.html

Pharmacologic Therapy for Heart Failure - FPIN's Help Desk Answers - American Family ...

Jul 1, 2019 - Compared with monotherapy, the combination of an ACE inhibitor and an ARB has not been shown to improve cardiovascular or overall mortality in patients with symptomatic heart failure. The combination is associated with an increased number of adverse drug effects.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2019/0701/p49.html

One Month of Dual Antiplatelet Therapy Followed by Clopidogrel Alone is Superior to 12 ...

Dec 15, 2019 - This study found that one month of dual antiplatelet therapy (aspirin plus clopidogrel or prasugrel [Effient]) followed by clopidogrel monotherapy for up to five years is both noninferior and superior to 12 months of dual antiplatelet therapy followed by aspirin for up to five years for...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1215/od5.html

Evaluating Benefits and Harms of Anticoagulation in Patients with Atrial Fibrillation -...

Dec 15, 2018 - In patients with NVAF, anticoagulants decrease the risk of stroke by approximately 60%. However, they also significantly increase the risk of a major bleeding event or intracranial hemorrhage.

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2018/1215/p751.html

Differences Between the AAFP Atrial Fibrillation Guideline and the AHA/ACC/HRS ...

Sep 1, 2017 - The AAFP updated its guideline on pharmacologic management of newly detected atrial fibrillation, which differs in part from the AHA/ACC/HRS guideline. It specifically highlights two questions commonly faced by family physicians, and is based on updated data from the Agency for ...

American Family Physician : Editorials

https://www.aafp.org/afp/2017/0901/p284.html

Should Family Physicians Follow the New ACC/AHA Cholesterol Treatment Guideline? Not ...

Aug 15, 2014 - The recommendations should have paid more attention to the inherent uncertainties in risk estimates and the importance of individual patient circumstances and preferences.

American Family Physician : Editorials: Controversies in Family Medicine

https://www.aafp.org/afp/2014/0815/p223.html

Bridging Warfarin Before Colonoscopy in Patients with Atrial Fibrillation - FPIN's ...

Apr 15, 2019 - A limited number of trials that examined the risk of temporary interruption of anticoagulation before a variety of procedures did not find a reduction in the risk of stroke, but they did show an increased risk of bleeding events and venous thromboembolism (VTE) in patients who were ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2019/0415/p519.html

Should Family Physicians Follow the New ACC/AHA Cholesterol Treatment Guideline? Yes: ...

Aug 15, 2014 - The recommendations appropriately focus treatment on those most likely to benefit.

American Family Physician : Editorials: Controversies in Family Medicine

https://www.aafp.org/afp/2014/0815/p212.html

Medication Management for Chronic Heart Failure with Preserved Ejection Fraction - ...

Jul 1, 2019 - Mineralocorticoid receptor antagonists reduce hospitalizations for patients with HFpEF. Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers have not been shown to change the morbidity or mortality in patients with HFpEF.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0701/p17.html

ACC/AHA Hypertension Guideline: What Is New? What Do We Do? - Editorials - American ...

Mar 15, 2018 - Choosing a threshold and target for treatment should be based on the science supporting CVD risk reduction, while considering the benefits and harms in individual patient circumstances and respecting patient choice.

American Family Physician : Editorials

https://www.aafp.org/afp/2018/0315/p372.html

Downsides of Detecting Atrial Fibrillation in Asymptomatic Patients - Editorials - ...

Mar 15, 2019 - Despite the lack of outcomes evidence, the rise of wearable ECG sensors will cause many individuals to seek care for misdiagnosed AF. The best intervention for patients with correct diagnoses remains unclear. Primary care physicians must use their skills in discussing uncertainty and ...

American Family Physician : Editorials

https://www.aafp.org/afp/2019/0315/p354.html

Coaching Patients About Successful Blood Pressure Management - Lown Right Care: ...

Mar 15, 2019 - A collaboration between AFP and the Lown Institute promotes a vision of delivering heath care that is based on the evidence, balanced in its approach, and focused on the patient.

American Family Physician : Lown Right Care: Reducing Overuse and Underuse

https://www.aafp.org/afp/2019/0315/p357.html

Blood Pressure Targets for Patients with Hypertension and Cardiovascular Disease - ...

Sep 1, 2018 - Achieving a target BP of 135/85 mm Hg or less does not decrease the risk of total cardiovascular events vs. treating to a target of 140 to 160/90 to 100 mm Hg. Further, treating to the lower BP target does not improve total mortality, cardiovascular mortality, or serious adverse effects.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/0901/p276.html

In Healthy Older Adults, Low-Dose Aspirin Increases All-Cause and Cancer-Specific ...

Jul 15, 2019 - The findings are completely unexpected. Although recent studies by this group and other groups of researchers have failed to find a cardiovascular benefit, likely because of better control of other cardiovascular risk factors, this study found increased all-cause mortality, primarily ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0715/p118a.html

Screening for Atrial Fibrillation with Electrocardiography: Recommendation Statement - ...

Mar 15, 2019 - The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for atrial fibrillation with electrocardiography.

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2019/0315/od1.html

Surgery or Lasers Preferred to Foam Sclerotherapy for Varicose Veins - POEMs - American...

May 15, 2020 - For symptomatic varicose veins at least 3 mm in diameter with evidence of saphenous vein reflux, laser ablation is the preferred initial therapy.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0515/p630a.html

Ivabradine (Corlanor) for Heart Failure - STEPS - American Family Physician

Apr 15, 2016 - In patients with stable systolic heart failure already on maximal medication therapy, adding ivabradine may reduce the number of hospitalizations related to heart failure (NNT for two years = 20), but it does not reduce cardiovascular mortality. In addition, many patients will not ...

American Family Physician : STEPS

https://www.aafp.org/afp/2016/0415/p682.html

Omega-3 Fatty Acids and Cardiovascular Disease - Implementing AHRQ Effective Health ...

May 1, 2018 - What is the effect of omega-3 fatty acid supplementation on cardiovascular outcomes?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2018/0501/p562.html

Influenza Vaccination for the Prevention of Cardiovascular Disease - Cochrane for ...

Mar 1, 2016 - Influenza vaccination may reduce cardiovascular mortality in patients with established cardiovascular disease. The effect of vaccination is unclear among patients in the general population without known cardiovascular disease.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2016/0301/p357.html

Apixaban (Eliquis) for Stroke Prevention in Atrial Fibrillation - STEPS - American ...

Apr 15, 2014 - Apixaban is at least as effective as aspirin or warfarin for preventing strokes in high-risk patients with nonvalvular atrial fibrillation, especially those who cannot or will not take warfarin. It is slightly less likely to cause major bleeding and may have better compliance because it...

American Family Physician : STEPS

https://www.aafp.org/afp/2014/0415/p672.html

ACE Inhibitors or ARBs to Prevent CKD in Patients with Microalbuminuria - FPIN's ...

Oct 15, 2016 - ACE inhibitors reduce the risk of progression to macroalbuminuria in normotensive patients with microalbuminuria and type 1 diabetes mellitus.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2016/1015/p652.html

Assessing Bleeding Risk in Patients Taking Anticoagulants - Point-of-Care Guides - ...

Oct 1, 2017 - Family physicians are often faced with the dilemma of balancing the benefit of stroke prevention with the risk of major bleeding when deciding on anticoagulation treatment in patients with atrial fibrillation. Over the past 10 years, several decision support tools have been developed ...

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2017/1001/p465.html

Chronic Critical Limb Ischemia: Diagnosis, Treatment and Prognosis - American Family ...

Apr 1, 1999 - Chronic critical limb ischemia is manifested by pain at rest, nonhealing wounds and gangrene. Ischemic rest pain is typically described as a burning pain in the arch or distal foot that occurs while the patient is recumbent but is relieved when the patient returns to a position in which...

American Family Physician : Article

https://www.aafp.org/afp/1999/0401/p1899.html

Vorapaxar (Zontivity) for the Prevention of Thrombotic Cardiovascular Events - STEPS - ...

Aug 15, 2015 - Vorapaxar should be limited to select patients with a history of MI or peripheral arterial disease who desire additional treatment for the prevention of MI.

American Family Physician : STEPS

https://www.aafp.org/afp/2015/0815/p304.html

Estimating Cardiovascular Risk - Point-of-Care Guides - American Family Physician

May 1, 2017 - The primary prevention of cardiovascular disease (CVD) depends on accurate estimation of cardiovascular risk. However, a recent systematic review identified 363 prediction models.

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2017/0501/p580.html

Diagnosis of Acute Coronary Syndrome - FPIN's Help Desk Answers - American Family ...

Aug 1, 2018 - The best test to diagnose ACS is a risk score based on a clinical prediction rule such as the HEART (history, electrocardiography, age, risk factors, troponin level) or TIMI (Thrombolysis in Myocardial Infarction) risk score, which have positive likelihood ratios (LR+'s) of 13 and 6.8, ...

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/0801/od2.html

A Primary Care Approach to the Patient with Claudication - American Family Physician

Feb 15, 2000 - Peripheral arterial occlusive disease occurs in about 18 percent of persons over 70 years of age. Usually, patients who have this disease present with intermittent claudication with pain in the calf, thigh or buttock that is elicited by exertion and relieved with a few minutes of rest. ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0215/p1027.html

Pioglitazone After Stroke or TIA Reduces Stroke and MI, but Also Has Significant Harms ...

Aug 15, 2016 - In patients with a recent stroke or TIA and evidence of insulin resistance, pioglitazone reduces the likelihood of myocardial infarction (MI) or stroke (number needed to treat [NNT] = 36 over five years) but increases the risk of significant weight gain (number needed to treat to harm ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0815/p319.html

Bedtime Instead of Morning Ingestion of Hypertension Medication Equals a Significantly ...

Apr 1, 2020 - This study found a significant reduction in mortality and morbidity among patients who took their once-daily anti-hypertensive medications at bedtime instead of in the morning. No significant difference occurred in compliance rates between bedtime and morning ingestion times. Individual...

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0401/p434a.html

Benefits and Harms for Low-Dose Aspirin in Patients with Diabetes Mellitus - POEMs - ...

Jun 1, 2019 - The 7,740 patients who took low-dose aspirin experienced 51 fewer vascular deaths, nonfatal myocardial infarctions, or nonfatal ischemic strokes; 29 fewer transient ischemic attacks; and 44 fewer revascularizations than patients who took placebo over a mean of 7.4 years.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0601/p718.html

Dual Antiplatelet Therapy for Patients with Cardiovascular Disease - FPIN's Clinical ...

Oct 15, 2019 - Patients with established cardiovascular disease or risk factors (e.g., ischemic cerebrovascular disease, peripheral arterial disease, high risk of atherothrombotic disease) should receive dual antiplatelet therapy with aspirin plus clopidogrel, which confers additional benefit over ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2019/1015/p463.html

Optimal Management of Cholesterol Levels and the Prevention of Coronary Heart Disease ...

Jan 15, 2002 - Coronary heart disease, the leading cause of death in women, is largely preventable. Lifestyle modifications (e.g., diet and exercise) are the cornerstone of primary and secondary prevention. Elevated levels of low-density lipoprotein cholesterol and triglycerides and low levels of ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0115/p217.html

Diagnosis of Stable Ischemic Heart Disease: Recommendations from the ACP - Practice ...

Oct 1, 2013 - The American College of Physicians (ACP), in collaboration with the American College of Cardiology Foundation, American Heart Association, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, and Society of Thoracic Surgeons, has developed a guideline...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2013/1001/p469.html

Pharmacologic Treatment of Hypertension in Adults Aged 60 Years or Older: A Guideline ...

May 1, 2017 - A high standard must be met when guidelines recommend lifelong preventive medications, knowing that at best, a small minority of patients will benefit and that all are risking harm.

American Family Physician : Editorials

https://www.aafp.org/afp/2017/0501/p547.html

Evolocumab (Repatha) for the Treatment of Hyperlipidemia - STEPS - American Family ...

Nov 15, 2016 - Evolocumab is generally safe and effective at lowering serum LDL cholesterol levels for select patients who need marked cholesterol reduction and can tolerate injections. However, it remains unknown whether evolocumab prevents premature death from cardiovascular events.

American Family Physician : STEPS

https://www.aafp.org/afp/2016/1115/p843.html

Early Cardioversion No Better Than Delayed Cardioversion for Recent-Onset Symptomatic ...

Nov 15, 2019 - For patients presenting to the emergency department with recent-onset symptomatic atrial fibrillation, early cardioversion is no better than delayed cardioversion in achieving sinus rhythm within four weeks.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1115/p648.html

Impact of Exercise-Based Cardiac Rehabilitation - Cochrane for Clinicians - American ...

Dec 1, 2016 - Exercise-based cardiac rehabilitation reduces cardiovascular mortality and hospitalization. There is no evidence that it reduces the rates of total mortality, myocardial infarctions, coronary artery bypass grafts, or percutaneous coronary interventions.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2016/1201/p881.html

Increased Readmissions and Adverse Events with Intensification of Antihypertensive ...

Feb 15, 2020 - The intensification of antihypertensive regimens on discharge in older adults hospitalized for noncardiac conditions is associated with an increased risk of readmission (number needed to harm [NNH] = 27) and medication-related serious adverse events (NNH = 63) within 30 days.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0215/p248a.html

The Case Against Routine Aspirin Use for Primary Prevention in Low-Risk Adults - ...

Jun 15, 2011 - A policy of generalized aspirin use in adults for the primary prevention of CVD is probably not warranted. Instead, the benefits and risks of aspirin therapy for primary prevention need to be considered on an individual basis, and should be reserved for persons at highest long-term risk...

American Family Physician : Editorials: Controversies in Family Medicine

https://www.aafp.org/afp/2011/0615/p1387.html

Peripheral Artery Disease Screening and Cardiovascular Disease Risk Assessment with the...

Dec 15, 2014 - J.P. is a 40-year-old man with a 15 pack-year smoking history. His father has type 2 diabetes mellitus. J.P.'s vital signs, weight, and lipid levels are within normal limits. At his office visit, he brings an advertisement for a health fair with information on screening for peripheral ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2014/1215/p859.html

For Three-Vessel Disease, but Not Left Main Disease, CABG Is Preferred Over PCI - POEMs...

Jun 1, 2020 - For patients with left main disease, PCI with a drug-eluting stent and CABG had similar all-cause mortality rates at 10 years. For those with three-vessel disease, CABG is associated with lower 10-year mortality.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0601/p698.html

Screening for High Blood Pressure in Adults - Putting Prevention into Practice - ...

Mar 15, 2016 - A 55-year-old black man presents for a blood pressure evaluation. He is trying to be more physically active and health conscious but has not seen a physician for five years. He takes no medications, has no concerns, and his physical examination findings are unremarkable. According to ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2016/0315/p511.html

Dapagliflozin in High-Risk Type 2 Diabetes Reduces Hospitalization for Heart Failure ...

Aug 1, 2019 - The only cardiovascular benefit to treatment with dapagliflozin was a reduction in the likelihood of hospitalization; 125 patients would need to be treated for 10 years to prevent one hospitalization.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0801/p184.html

Should Family Physicians Use Coronary Artery Calcium Scores to Screen for Coronary ...

Sep 1, 2012 - No: Screening is Unproven, Expensive, and Potentially Harmful. Coronary artery calcium (CAC) scores have been recommended as a way to screen for coronary artery disease (CAD). Before we get too enthusiastic about this expensive new test, remember that a good screening test must perform ...

American Family Physician : Editorials: Controversies in Family Medicine

https://www.aafp.org/afp/2012/0901/p405.html

Should Family Physicians Use Coronary Artery Calcium Scores to Screen for Coronary ...

Sep 1, 2012 - Yes: Screening Improves CAD Risk Management in Selected Patients. Sudden death is often the first manifestation of atherosclerotic coronary artery disease (CAD). One-third of deaths from CAD in the Atherosclerosis Risk in Communities study occurred without warning signs, and there was ...

American Family Physician : Editorials: Controversies in Family Medicine

https://www.aafp.org/afp/2012/0901/p398.html

Simple Clinical Prediction Rule Determines Risk of Heart Failure with Preserved ...

May 15, 2019 - A simple clinical prediction rule using noninvasive data can identify patients at low, moderate, and high risk for HFPEF.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0515/od3.html

Omega-3 Oil Does Not Reduce Serious Cardiovascular Events for Patients with Diabetes ...

Jul 15, 2019 - In this study, there was no significant difference in the likelihood of a composite vascular outcome or all-cause mortality in patients given an omega-3 fatty acid supplement compared with those given an olive oil placebo.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0715/p120.html

Niacin Does Not Decrease Mortality in Patients with Coronary Artery Disease or Low HDL ...

Jul 15, 2017 - We are now flush with data about the effects of niacin in patients with elevated cholesterol levels. Despite its ability to raise high-density lipoprotein (HDL) serum cholesterol levels, it does not add additional mortality or morbidity benefit to statin treatment. Patients with ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0715/p129.html

Vitamin D Is Not Effective as Primary Prevention of Cardiovascular Disease or Cancer - ...

Sep 15, 2019 - Vitamin D supplementation does not prevent cardiovascular events or cancer in mostly nondiabetic adults (men 50 years and older, women 55 years and older).

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0915/p374.html

Ticagrelor (Brilinta) for Secondary Prevention of Thrombotic Events Following Acute ...

Dec 15, 2013 - Ticagrelor is an alternative to clopidogrel for secondary prevention of cardiovascular death in patients with acute coronary syndrome. In an international study it was found to be more effective, but patients in the United States did not experience superior outcomes.

American Family Physician : STEPS

https://www.aafp.org/afp/2013/1215/p821.html

Contemporary Management of Angina: Part II. Medical Management of Chronic Stable Angina...

Jan 1, 2000 - Except for a small subset of patients with angina whose survival is improved with coronary artery bypass surgery, chronic stable angina can be appropriately managed with medical therapy in the vast majority of patients. Drug therapy includes aspirin, beta-adrenergic blockers, ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0101/p129.html

Statins Ineffective for Primary Prevention of Cardiovascular Disease in Patients 75 ...

Apr 1, 2019 - In this retrospective study, statin treatment in patients 75 years or older without preexisting CVD did not change the likelihood of developing CVD or reduce any-cause mortality. However, patients 75 to 84 years of age with diabetes mellitus benefitted from treatment. These results ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0401/p461.html

Omega-3 Fatty Acid Supplementation Does Not Decrease CVD-Related Outcomes - POEMs - ...

Nov 1, 2014 - Omega-3 fatty acid supplementation does not decrease the risk of cardiovascular outcomes in this older population. Although the numbers are small, supplementation may prevent heart disease in patients already at low risk; that is, patients without a history of cardiovascular disease ...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/1101/p662.html

Statins for Primary Cardiovascular Prevention - Cochrane for Clinicians - American ...

Oct 1, 2011 - Trials to date have found that statins reduce all-cause mortality, composite cardiovascular outcomes, and revascularization. However, most trials included large numbers of persons with known CVD. Clear evidence of the effectiveness of statins to prevent a first cardiovascular event is ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2011/1001/p767.html

Aspirin for the Prevention of Cardiovascular Disease - Putting Prevention into Practice...

Jun 15, 2011 - Case study: K.T., a 48-year-old man, presents for a routine office visit. He is worried about cardiovascular disease (CVD) and asks whether he should take daily aspirin to lower his risk. His blood pressure is 120/60 mm Hg, and his total cholesterol is 180 mg per dL (4.66 mmol per L), ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2011/0615/p1469.html

Influenza Vaccine Reduces Risk of Adverse Cardiovascular Events in High-Risk Patients -...

Feb 1, 2014 - This meta-analysis found that the influenza vaccine is associated with a significantly lower risk of major adverse cardiovascular events in adults with coronary disease. The benefit of influenza vaccination is strongest in adults with a history of recent acute coronary syndrome within ...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0201/p224a.html

Apolipoproteins for Cardiovascular Risk Assessment - FPIN's Clinical Inquiries - ...

Apr 15, 2014 - Measurement of apolipoprotein B and apolipoprotein A-I is no better than traditional lipid measurements and should not be used to predict cardiovascular risk.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2014/0415/od2.html

The JUPITER Study: Biomarkers Plus Statin vs. Lifestyle Modification for Preventing ...

Mar 15, 2009 - ...COLIN KOPES-KERR, MD, Santa Rosa Family Medicine Residency, Santa Rosa, California MARK EBELL, MD, MS, University of Georgia, Athens, Georgia Am Fam Physician. 2009 Mar 15;79(6):438-442. The JUPITER (Justification for the Use of Statins in Prevention: An Intervention Trial...

American Family Physician : Editorials

https://www.aafp.org/afp/2009/0315/p438.html

The Heart of Women's Health - Editorials - American Family Physician

Oct 15, 2006 - ...DEBORAH S. PLATE, D.O. and SUZANNE HUGHES, M.S.N., R.N., Akron General Center for Family Medicine, Akron, Ohio Am Fam Physician. 2006 Oct 15;74(8):1285-1286. Related Article Cardiovascular disease (CVD) is the leading cause of death among women and has claimed the lives of more...

American Family Physician : Editorials

https://www.aafp.org/afp/2006/1015/p1285.html

Screening for Abdominal Aortic Aneurysm: Recommendation Statement - U.S. Preventive ...

Jun 1, 2005 - This statement summarizes the U.S. Preventive Services Task Force (USPSTF) recommendations on screening for abdominal aortic aneurysm (AAA) and the supporting scientific evidence and updates the 1996 recommendations contained in the Guide to Clinical Preventive Services, 2d ed.

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2005/0601/p2144.html

Screening for Abdominal Aortic Aneurism - Putting Prevention into Practice - American ...

Jun 1, 2005 - Case study: M.G., a 70-year-old black man, requests refills for his medicines. His medications include lisinopril, atorvastatin, glipizide, and daily aspirin. He smoked heavily when he was younger but quit about 15 years ago. He also asks that you order whatever tests should be done at ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2005/0601/p2154.html

Aspirin for the Primary Prevention of Cardiovascular Events - Putting Prevention into ...

Nov 1, 2002 - Case study: ST is a 55-year-old man who you see regularly for hypertension and depression. He is overweight and sedentary, and his elder sister recently had a heart attack. He asks you whether he should take a daily aspirin, just in case.

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2002/1101/p1737.html

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