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Medicine by the numbers

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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

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

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

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

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

Antihypertensive Drug Therapy for Mild to Moderate Hypertension During Pregnancy - ...

Oct 1, 2019 - Compared with placebo, antihypertensive drug therapy for mild to moderate hypertension (defined by the authors as a blood pressure of 140 to 169 mm Hg systolic or 90 to 109 mm Hg diastolic) caused by chronic hypertension, gestational hypertension, or preeclampsia during pregnancy does ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/1001/p403.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

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

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

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

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

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

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

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

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

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

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

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

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

Intensive Blood Pressure Control in Older Patients Can Decrease Renal Function - POEMs ...

Jan 1, 2018 - In this post-hoc analysis of the previously published SPRINT trial, lowering the systolic blood pressure of patients who are at increased risk of cardiovascular events (average age = 66 years) will decrease their risk of cardiovascular disease but increase their likelihood of developing...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0101/p54.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

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

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

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

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

Perioperative Cardiovascular Medication Management in Noncardiac Surgery: Common ...

May 15, 2017 - Several medications have been used perioperatively in patients undergoing noncardiac surgery in an attempt to improve outcomes. Antiplatelet therapy for primary prevention of cardiovascular events should generally be discontinued seven to 10 days before surgery to avoid increasing the ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0515/p645.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

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

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

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

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

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

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

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

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

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

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

Some Benefit to Treating Mild Hypertension to Prevent Stroke, CV Deaths, and Overall ...

Dec 1, 2015 - Treating mild hypertension over five years decreases the risk of stroke, cardiovascular (CV) death, and overall mortality in a small proportion of patients.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1201/p1020.html

Calcium Supplementation for Preventing Hypertensive Disorders in Pregnancy - Cochrane ...

Oct 1, 2015 - High-dose calcium supplementation (i.e., at least 1,000 mg per day) during pregnancy reduces the risk of developing hypertension and preeclampsia. The most significant risk reduction occurs in women at risk of hypertensive disorders and those with low-calcium diets.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2015/1001/p570.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

Increased GI Bleeding After Switch from Warfarin to Dabigatran - POEMs - American ...

May 1, 2015 - The risk of bleeding increases (though remains small) when patients with atrial fibrillation are switched from warfarin to dabigatran to prevent stroke or transient ischemic attack. This study, conducted almost exclusively in male veterans, found an increase in gastrointestinal (GI) ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0501/p648.html

Thrombolysis for DVT: Has the Time Arrived? - AFP Journal Club - American Family Physician

Apr 1, 2015 - Catheter-directed thrombolysis for proximal DVT is experimental but may be considered in a patient with phlegmasia and resulting compartment syndrome.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2015/0401/p430.html

Post-Myocardial Infarction Beta Blockers Do Not Decrease Mortality - POEMs - American ...

Mar 15, 2015 - Although recommended by guidelines and used as a so-called quality indicator of hospital care, the use of beta blockers following myocardial infarction, when combined with optimal acute and chronic treatment, does not provide a further survival benefit.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0315/p402a.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

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

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

Colchicine Effective for First Episode of Acute Pericarditis - POEMs - American Family ...

Feb 1, 2014 - When used in addition to conventional anti-inflammatory therapy, colchicine decreases the rate of incessant or recurrent pericarditis. You would need to treat four patients with colchicine to prevent one such episode.

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0201/p226.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

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

Updated Guidelines on Outpatient Anticoagulation - American Family Physician

Apr 15, 2013 - The American College of Chest Physicians provides recommendations for the use of anticoagulant medications for several indications that are important in the primary care setting. Warfarin, a vitamin K antagonist, is recommended for the treatment of venous thromboembolism and for the ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0415/p556.html

Rivaroxaban vs. Warfarin for Stroke Prevention in Patients with Nonvalvular Atrial ...

Mar 15, 2012 - How does rivaroxaban compare with warfarin for stroke prevention in patients with nonvalvular atrial fibrillation? This study concluded that rivaroxaban is noninferior to warfarin. However, noninferiority trials do not meet the same rigorous design and statistical format of traditional ...

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2012/0315/p577.html

Medical Management of Stable Coronary Artery Disease - American Family Physician

Apr 1, 2011 - All patients with stable coronary artery disease require medical therapy to prevent disease progression and recurrent cardiovascular events. Three classes of medication are essential to therapy: lipid-lowering, antihypertensive, and antiplatelet agents. Lipid-lowering therapy is ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0401/p819.html

Should We Treat Moderately Elevated Triglycerides? No: Reducing Moderately Elevated ...

Feb 1, 2011 - Moderately elevated triglyceride levels have not been established as an independent risk factor for CHD. More importantly, the lowering of moderately elevated triglyceride levels with drug therapy has not been shown to decrease the rate of CHD for primary prevention in otherwise healthy...

American Family Physician : Editorials: Controversies in Family Medicine

https://www.aafp.org/afp/2011/0201/p246.html

Sudden Cardiac Death and Implantable Cardioverter-Defibrillators - American Family ...

Dec 1, 2010 - Sudden cardiac death is a major public health problem, affecting 500,000 patients in the United States annually. An implantable cardioverter-defibrillator (ICD) can terminate malignant ventricular arrhythmias and has been shown to improve survival in high-risk populations. Although ...

American Family Physician : Article

https://www.aafp.org/afp/2010/1201/p1357.html

For Hyperlipidemia, Go Where the Evidence Takes You: Give a Statin and Nothing Else - ...

Nov 1, 2010 - Only statins have patient-oriented evidence supporting their role in reducing all-cause mortality. The NCEP–ATP III guidelines offer a nine-step approach for reaching target lipid levels, but the application to everyday practice is far simpler: If a patient with hyperlipidemia has ...

American Family Physician : Editorials: Controversies in Family Medicine

https://www.aafp.org/afp/2010/1101/p1063.html

The Role of Nonstatin Therapy in Managing Hyperlipidemia - Editorials: Controversies in...

Nov 1, 2010 - When treating hyperlipidemia, physicians often face the question of the clinical value of nonstatin drugs, including bile acid sequestrants, fibrates (fibric acid derivatives), niacin, and cholesterol-absorption inhibitors. This editorial highlights the most prominent trial data and ...

American Family Physician : Editorials: Controversies in Family Medicine

https://www.aafp.org/afp/2010/1101/p1056.html

ACCP Releases Statement on Dyspnea Treatment in Patients with Advanced Lung or Heart ...

Oct 15, 2010 - The American College of Chest Physicians (ACCP) wrote a consensus statement to influence clinical practice and provide suggestions regarding the management of dyspnea in patients with advanced lung or heart disease.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2010/1015/p999.html

Hypothermia for Neuroprotection in Adults After Cardiopulmonary Resuscitation - ...

Sep 1, 2010 - Compared with standard care, therapeutic hypothermia with conventional cooling methods improves the rate of survival to hospital discharge and neurologic outcome in patients successfully resuscitated after cardiac arrest.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2010/0901/p477.html

First-Line Treatment for Hypertension - Cochrane for Clinicians - American Family ...

Jun 1, 2010 - In comparing the effects of thiazide diuretics, beta blockers, angiotensin-converting enzyme (ACE) inhibitors, and calcium channel blockers (CCBs) with placebo, thiazide diuretics lowered mortality and morbidity from stroke, heart attack, and heart failure more than beta blockers.1 ACE ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2010/0601/p1333.html

Diet and Exercise in the Management of Hyperlipidemia - American Family Physician

May 1, 2010 - Dietary factors that influence lipid levels include modification of nutritional components, consumption of specific foods, use of food additives and supplements, and major dietary approaches. The most beneficial changes result from reducing intake of saturated and trans fats; increasing...

American Family Physician : Article

https://www.aafp.org/afp/2010/0501/p1097.html

Drug-Eluting Coronary Artery Stents - American Family Physician

Dec 1, 2009 - Many advances have been made in the percutaneous treatment of coronary artery disease during the past 30 years. Although balloon angioplasty alone is still performed, the use of coronary artery stents is much more common. Approximately 40 percent of patients treated with balloon ...

American Family Physician : Article

https://www.aafp.org/afp/2009/1201/p1245.html

Cardiac Rehabilitation - American Family Physician

Nov 1, 2009 - An estimated 80 million (nearly one in three) Americans have cardiovascular disease, which is the leading cause of morbidity and mortality worldwide. In the United States alone, more than 850,000 deaths are attributed annually to cardiovascular disease, and more than 8 million Americans...

American Family Physician : Article

https://www.aafp.org/afp/2009/1101/p955.html

Is the San Francisco Syncope Rule Reliable? - AFP Journal Club - American Family Physician

Sep 15, 2009 - Can the San Francisco Syncope Rule successfully determine which patients can be safely discharged after an acute syncopal episode? External validation suggests that the sensitivity of the rule is lower than first reported. Physicians need to apply their clinical acumen and override the ...

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2009/0915/p558.html

Heparins for Unstable Angina and Non-ST-Segment Elevation Myocardial Infarction - ...

Apr 1, 2009 - Compared with standard therapy with aspirin, the use of heparin does not reduce mortality, the need for revascularization, and recurrent angina. Heparin does reduce the occurrence of myocardial infarction (MI; number needed to treat [NNT] = 33), defined as typical chest pain associated ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2009/0401/p560.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

Aspirin in Patients with Actue Ischemic Stroke - FPIN's Clinical Inquiries - American ...

Feb 1, 2009 - Aspirin in a daily dose of 160 to 300 mg initiated within 48 hours of symptom onset results in a net decrease in morbidity and mortality caused by acute ischemic stroke, based on a systematic review), regardless of the availability of computed tomography (CT).

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2009/0201/p226.html

Pharmacologic Management of Hypertension in Patients with Diabetes - American Family ...

Dec 1, 2008 - Hypertension is a common comorbidity in patients with diabetes, and adequate control of blood pressure significantly reduces the risk of macrovascular and microvascular complications. Patients with diabetes should achieve a target blood pressure of less than 130/80 mm Hg. The use of ...

American Family Physician : Article

https://www.aafp.org/afp/2008/1201/p1277.html

Managing Hypertension Using Combination Therapy - American Family Physician

May 1, 2008 - Combination therapy of hypertension with separate agents or a fixed-dose combination pill offers the potential to lower blood pressure more quickly, obtain target blood pressure, and decrease adverse effects. Antihypertensive agents from different classes may offset adverse reactions ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0501/p1279.html

Oral Anticoagulants vs. Antiplatelet Therapy - Cochrane for Clinicians - American ...

May 1, 2008 - Compared with antiplatelet therapy, oral anticoagulation significantly reduces stroke at an average follow-up of one to three years, but does not reduce mortality. Intracranial or extracranial hemorrhage is more common with anticoagulation and must be weighed against its therapeutic ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2008/0501/p1250.html

Pharmacologic Management of Heart Failure Caused by Systolic Dysfunction - American ...

Apr 1, 2008 - Heart failure caused by systolic dysfunction affects more than 5 million adults in the United States and is a common source of outpatient visits to primary care physicians. Mortality rates are high, yet a number of pharmacologic interventions may improve outcomes. Other interventions, ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0401/p957.html

Are Beta Blockers Effective First-line Treatments for Hypertension? - Cochrane for ...

Nov 1, 2007 - Current evidence does not support the use of beta blockers as initial therapy for hypertension.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2007/1101/p1306.html

Aliskiren (Tekturna) for the Treatment of Hypertension - STEPS - American Family Physician

Oct 15, 2007 - Aliskiren provides a new pharmacologic approach to treating hypertension; however, short-term studies have not identified a unique role. It is more expensive than commonly used first-line diuretics, and long-term safety has not been demonstrated.

American Family Physician : STEPS

https://www.aafp.org/afp/2007/1015/p1203.html

Best Alternatives to Statins for Treating Hyperlipidemia - FPIN's Clinical Inquiries - ...

Oct 1, 2007 - Most alternatives to statin therapy reduce cholesterol levels but do not consistently demonstrate a reduction in cardiac-related and all-cause mortality in patients with or without coronary heart disease (CHD). Fibrates and niacin decrease the risk of major coronary events; however, no ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2007/1001/p1027.html

Atrial Fibrillation (Chronic) - Clinical Evidence Handbook - American Family Physician

Sep 1, 2007 - What are the effects of oral medical treatments to control heart rate in persons with chronic (longer than one week) nonvalvular atrial fibrillation? What is the effect of different treatment strategies for persons with persistent nonvalvular atrial fibrillation?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2007/0901/p701.html

Interventions to Improve Blood Pressure Control in Patients with Hypertension - ...

Aug 1, 2007 - One large study of adults with hypertension showed that a rigorous, systematic program including regular patient review and aggressive antihypertensive drug therapy improved systolic and diastolic blood pressure and reduced all-cause mortality (7.8 to 6.4 percent at five years; number ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2007/0801/p373.html

Home Monitoring of Glucose and Blood Pressure - American Family Physician

Jul 15, 2007 - Home monitoring of blood glucose and blood pressure levels can provide patients and physicians with valuable information in the management of diabetes mellitus and hypertension. Home monitoring allows patients to play an active role in their care and may improve treatment adherence and ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0715/p255.html

U.S. Statin Guidelines: Expensive but Not Necessarily Effective - Editorials - American...

May 15, 2007 - ...HENRY C. BARRY, MD, MS, Michigan State University College of Human Medicine, East Lansing, Michigan JEROME R. HOFFMAN, MD, MA, David Geffen School of Medicine at the University of California at Los Angeles, Los Angeles, California Am Fam Physician. 2007 May 15;75(10):1453-1459....

American Family Physician : Editorials

https://www.aafp.org/afp/2007/0515/p1453.html

Management of Hypertriglyceridemia - American Family Physician

May 1, 2007 - Hypertriglyceridemia is associated with an increased risk of cardiovascular events and acute pancreatitis. Along with lowering low-density lipoprotein cholesterol levels and raising high-density lipoprotein cholesterol levels, lowering triglyceride levels in high-risk patients (e.g., ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0501/p1365.html

Outpatient Management of Anticoagulation Therapy - American Family Physician

Apr 1, 2007 - The Seventh American College of Chest Physicians (ACCP) Conference on Antithrombotic and Thrombolytic Therapy provides guidelines for outpatient management of anticoagulation therapy. The ACCP guidelines recommend short-term warfarin therapy, with the goal of maintaining an ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0401/p1031.html

Early Invasive Therapy or Conservative Management for Unstable Angina or NSTEMI? - ...

Jan 1, 2007 - Compared with conservative management, early invasive treatment of patients with UA or NSTEMI using coronary angiography with or without revascularization reduces rehospitalization and refractory angina within the first year and significantly reduces mortality and myocardial infarction ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2007/0101/p47.html

Digoxin Therapy for Heart Failure: An Update - American Family Physician

Aug 15, 2006 - Digoxin therapy has long been used to treat heart failure; however, its effectiveness was not completely known until recently. Results of the Digitalis Investigation Group trial showed that adding digoxin to standard heart failure therapy had no effect on mortality. However, adding ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0815/p613.html

Nonpharmacologic Strategies for Managing Hypertension - American Family Physician

Jun 1, 2006 - The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure recommends lifestyle modification for all patients with hypertension or prehypertension. Modifications include reducing dietary sodium to less than 2.4 g per ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0601/p1953.html

Nutritional Assessment and Counseling for Prevention and Treatment of Cardiovascular ...

Jan 15, 2006 - Physicians face several barriers to counseling their patients about nutrition, including conflicting evidence of the benefit of counseling, limited training and understanding of the topic, and imperfect and varied guidelines to follow. Because cardiovascular disease remains the leading ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0115/p257.html

Pharmacologic Cardioversion for Atrial Fibrillation and Flutter - Cochrane for ...

Dec 1, 2005 - There is no evidence that rhythm control in older patients with atrial fibrillation is more effective than rate control for improving patient-oriented outcomes.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2005/1201/p2217.html

Statin Therapy in Patients with Type 2 Diabetes - FPIN's Clinical Inquiries - American ...

Sep 1, 2005 - Based on current evidence, statin therapy should be offered to all patients with type 2 diabetes who are known to have coronary artery disease.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2005/0901/p866.html

Choosing Between Warfarin (Coumadin) and Aspirin Therapy for Patients with Atrial ...

Jun 15, 2005 - Pooled data from randomized trials show that warfarin reduces the risk of stroke from 4.5 percent to 1.4 percent per year in patients with nonvalvular atrial fibrillation and no history of stroke or transient ischemic attack (TIA).

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2005/0615/p2348.html

Improving Adherence to Treatment for Hypertension - Cochrane for Clinicians - American ...

Jun 1, 2005 - The most effective strategy to improve patient compliance with antihypertensive medication is to simplify the dosing regimen. There is more limited evidence to support a variety of motivational strategies. Patient education alone is ineffective.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2005/0601/p2089.html

Treatment of Calf Deep Venous Thrombosis - FPIN's Clinical Inquiries - American Family ...

Jun 1, 2005 - Patients with a first episode of calf DVT with a transient risk factor should receive heparin therapy followed by oral anticoagulation for six to 12 weeks.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2005/0601/p2157.html

Indications and Recommendations for Pacemaker Therapy - American Family Physician

Apr 15, 2005 - Each year, pacemaker therapy is prescribed to approximately 900,000 persons worldwide. Current pacemaker devices treat bradyarrhythmias and tachyarrhythmias and, in some cases, are combined with implantable defibrillators. In older patients, devices that maintain synchrony between atria...

American Family Physician : Article

https://www.aafp.org/afp/2005/0415/p1563.html

Treatment of Cholesterol Abnormalities - American Family Physician

Mar 15, 2005 - Cardiovascular disease and its subset coronary heart disease are leading causes of morbidity and mortality in the United States and worldwide. In general, higher levels of low-density lipoprotein cholesterol are associated with an increased risk of coronary heart disease, myocardial ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0315/p1137.html

Antiplatelet Therapy and Anticoagulation in Patients with Hypertension - Cochrane for ...

Mar 1, 2005 - Antiplatelet agents should not be used in patients with hypertension and no previous history of heart attack or stroke. However, these agents are recommended for use in hypertensive patients who already have vascular disease. Anticoagulants should not be used for prevention of vascular ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2005/0301/p897.html

Evidence-Based Initiation of Warfarin (Coumadin) - Point-of-Care Guides - American ...

Feb 15, 2005 - Many physicians continue to use clinical judgment alone as the basis for initiating and adjusting warfarin dosages in patients who require oral anticoagulation. A number of studies have validated approaches to initiation of anticoagulation that provide more rapid anticoagulation with ...

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2005/0215/p763.html

Management of Hypertension in Older Persons - American Family Physician

Feb 1, 2005 - Antihypertensive therapy has been shown to reduce morbidity and mortality in older patients with elevated systolic or diastolic blood pressures. This benefit appears to persist in patients older than 80 years, but less than one third of older patients have adequate blood pressure ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0201/p469.html

Linking the Hospital and the Office in Cardiovascular Secondary Prevention - Editorials...

Feb 1, 2005 - ...Published data from GWTG8 demonstrate significant improvement in the number of patients who receive guideline-recommended secondary prevention measures before post-hospital follow-up. Too often, time in the office is spent on the more difficult task of educating patients about the...

American Family Physician : Editorials

https://www.aafp.org/afp/2005/0201/p430.html

Outpatient Treatment of Systolic Heart Failure - American Family Physician

Dec 1, 2004 - Optimal outpatient treatment of systolic heart failure has three goals that should be pursued simultaneously: (1) control of risk factors for the development and progression of heart failure, (2) treatment of heart failure, and (3) education of patients. Control of risk factors includes...

American Family Physician : Article

https://www.aafp.org/afp/2004/1201/p2157.html

Prognosis for Patients Undergoing Coronary Angioplasty - Point-of-Care Guides - ...

Nov 15, 2004 - Percutaneous coronary interventions, such as balloon angioplasty, with or without stent placement, are important in the treatment of patients with coronary artery disease.

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2004/1115/p1966.html

ACC/AHA Release Guidelines on Management of Patients with STEMI: Hospital and Long-Term...

Nov 1, 2004 - Guidelines for the management of ST-elevation myo-cardial infarction (STEMI), focusing on prevention and management in the emergency department, are available from the American College of Cardiology (ACC)/American Heart Association (AHA) Task Force on Practice Guidelines.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2004/1101/p1800.html

Which Patients with Atrial Fibrillation Do Not Need Anticoagulation Therapy with ...

Sep 1, 2004 - Anticoagulation therapy with warfarin is not indicated for use in patients with non-valvular atrial fibrillation who are at low risk for embolic cerebral vascular events. The classification of low risk for embolic stroke is defined as a 1 percent annual risk for stroke or lone atrial ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2004/0901/p917.html

ACP Releases Guideline on Lipid Control in Patients with Type 2 Diabetes Mellitus - ...

Aug 15, 2004 - A guideline on the management of dyslipidemia, particularly hypercholesterolemia, in patients with type 2 diabetes mellitus has been published by the Clinical Efficacy Assessment Subcommittee of the American College of Physicians (ACP).

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2004/0815/p775.html

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