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Medicine by the numbers

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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

ACC Statement on Preparticipation Cardiovascular Screening for Competitive Athletes - ...

Aug 1, 2005 - The American College of Cardiology (ACC) has released new eligibility guidelines for competitive athletes with cardiovascular abnormalities and clinical guidelines for preparticipation screening.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2005/0801/p523.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

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

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

ACE Inhibitor Therapy: Benefits and Underuse - Editorials - American Family Physician

Jan 1, 1999 - ...SIDNEY C. SMITH, JR., M.D., University of North Carolina at Chapel Hill, School of Medicine, Chapel Hill, North Carolina Am Fam Physician. 1999 Jan 1;59(1):35-. During the past decade, several landmark trials have confirmed the benefits of angiotensin converting enzyme (ACE)...

American Family Physician : Editorials

https://www.aafp.org/afp/1999/0101/p35.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

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

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

Acute Pericarditis - American Family Physician

Nov 15, 2007 - Although acute pericarditis is most often associated with viral infection, it may also be caused by many diseases, drugs, invasive cardiothoracic procedures, and chest trauma. Diagnosing acute pericarditis is often a process of exclusion. A history of abrupt-onset chest pain, the ...

American Family Physician : Article

https://www.aafp.org/afp/2007/1115/p1509.html

Acute Pericarditis: Diagnosis and Management - American Family Physician

Apr 1, 2014 - Acute pericarditis, inflammation of the pericardium, is found in approximately 5% of patients admitted to the emergency department for chest pain unrelated to acute myocardial infarction. It occurs most often in men 20 to 50 years of age. Acute pericarditis has a number of potential ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0401/p553.html

Advances in the Treatment of Arrhythmias: Implantable Cardioverter-Defibrillators - ...

Jan 15, 1998 - Implantable cardioverter-defibrillators are commonly used in patients who have life-threatening ventricular arrhythmias. With these implanted electronic devices, bradyarrhythmias and tachyarrhythmias can be recognized promptly and treated with electrical pacing, cardioversion or ...

American Family Physician : Article

https://www.aafp.org/afp/1998/0115/p297.html

AHA Examines Cardiovascular Problems in Diabetes - Practice Guidelines - American ...

Jan 15, 2000 - The American Heart Association (AHA) has issued recommendations for interventions to reduce the risk of cardiovascular complications in patients with diabetes mellitus.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2000/0115/p561.html

AHA Releases Statement on Physical Activity Interventions - Practice Guidelines - ...

Jul 15, 2007 - The American Heart Association (AHA) has released a summary statement on physical activity interventions with the aim to provide an overview of their population-wide impact.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2007/0715/p297.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

Amiodarone: Guidelines for Use and Monitoring - American Family Physician

Dec 1, 2003 - Amiodarone is a potent antiarrhythmic agent that is used to treat ventricular arrhythmias and atrial fibrillation. The drug prevents the recurrence of life-threatening ventricular arrhythmias and produces a modest reduction of sudden deaths in high-risk patients. Amiodarone is more ...

American Family Physician : Article

https://www.aafp.org/afp/2003/1201/p2189.html

An Approach to Diagnosis and Initial Management of Systemic Vasculitis - American ...

Oct 1, 1999 - Systemic vasculitis occurs in a heterogeneous group of primary disorders or can be a manifestation of infection, an adverse drug reaction, malignancy or a connective tissue disease. A vasculitic process should be suspected in patients with unexplained ischemia or multiple organ ...

American Family Physician : Article

https://www.aafp.org/afp/1999/1001/p1421.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

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

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

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

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

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

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

Arrhythmogenic Right Ventricular Dyplasia - American Family Physician

Apr 15, 2006 - Arrhythmogenic right ventricular dysplasia (ARVD) is a disorder in which normal myocardium is replaced by fibrofatty tissue. This disorder usually involves the right ventricle, but the left ventricle and septum also may be affected. Although the exact prevalence of ARVD is unknown, it ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0415/p1391.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

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

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

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

Assessment and Treatment of Depression Following Myocardial Infarction - American ...

Aug 15, 2001 - Approximately 65 percent of patients with acute myocardial infarction report experiencing symptoms of depression. Major depression is present in 15 to 22 percent of these patients. Depression is an independent risk factor in the development of and mortality associated with ...

American Family Physician : Article

https://www.aafp.org/afp/2001/0815/p641.html

Atrial Fibrillation - American Family Physician

Oct 1, 2019 - 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

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

Attenuating Cardiovascular Risk Factors in Patients with Type 2 Diabetes - American ...

Dec 15, 2000 - Patients with type 2 diabetes (formerly known as non-insulin-resistant diabetes) have a significantly increased risk of developing cardiovascular disease. Once clinical cardiovascular disease develops, these patients have a poorer prognosis than normoglycemic patients. By inducing ...

American Family Physician : Article

https://www.aafp.org/afp/2000/1215/p2633.html

Automated Ambulatory Blood Pressure Monitoring: Clinical Utility in the Family Practice...

Jun 1, 2003 - Although the percentage of patients who are treated for hypertension has increased, the percentage of those who demonstrate control of blood pressure has declined. As a result of this trend, clinicians may increasingly rely on ambulatory blood pressure monitoring to improve the ...

American Family Physician : Article

https://www.aafp.org/afp/2003/0601/p2343.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

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

Beta Blockers and Noncardiac Surgery: Why the POISE Study Alone Should Not Change Your ...

Mar 15, 2010 - Should we stop using beta blockers to prevent myocardial infarction in persons undergoing noncardiac surgery? The data remain inconclusive. Although the POISE study is an important contribution to the literature, it uses a protocol that is unrealistic and should not change current ...

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2010/0315/p717.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

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

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

Calcium Channel Antagonists: Morbidity and Mortality - What's the Evidence? - American ...

Apr 1, 1998 - Recent studies have shown an association between the use of calcium channel antagonists for the treatment of hypertension and an increased risk of myocardial infarction, gastrointestinal hemorrhage and cancer. The interpretation of the results of these studies and their application to ...

American Family Physician : Article

https://www.aafp.org/afp/1998/0401/p1551.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

Can ECG Rule Out ACS if Performed While the Patient Is Having Chest Pain? - AFP Journal...

Nov 15, 2010 - Is negative ECG performed while the patient is having chest pain good at ruling out acute coronary syndrome? Although this study says yes, other higher-quality studies say it does not rule out cardiac disease. Observational studies are not ideal for testing some hypotheses.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2010/1115/p1185.html

Can Reduced or Modified Dietary Fat Prevent Cardiovascular Disease? - Cochrane for ...

Jan 1, 2002 - Reducing or modifying the amount or type of fat in a patient's diet and replacing it with polyunsaturated fats will not significantly reduce the risk of death from all causes of cardiovascular disease but could reduce the risk of an important cardiovascular disease event by 16 percent. ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2002/0101/p53.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

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

Cardiovascular Screening of Student Athletes - American Family Physician

Aug 15, 2000 - Each year, a number of children and adolescents die suddenly from cardiac problems that are associated with a small subgroup of disorders and high-risk behaviors. While sudden cardiac death in any child or adolescent is distressing, it can be particularly devastating when it occurs in a...

American Family Physician : Article

https://www.aafp.org/afp/2000/0815/p765.html

Cholesterol Treatment Guidelines Update - American Family Physician

Mar 1, 2002 - Hypercholesterolemia is one of the major contributors to atherosclerosis and coronary heart disease in our society. The National Cholesterol Education Program of the National Institutes of Health has created a set of guidelines that standardize the clinical assessment and management of ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0301/p871.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

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

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

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

Combination Therapy with ACE Inhibitors and Angiotensin-Receptor Blockers in Heart ...

Nov 1, 2003 - Angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers have different pharmacologic mechanisms for blocking the effect of the renin-angiotensin-aldosterone system on the cardiovascular system. Pharmacologically, the combination of these drug classes completely blocks...

American Family Physician : Article

https://www.aafp.org/afp/2003/1101/p1795.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

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

Oct 15, 2010 - The most common types of supraventricular tachycardia are caused by a reentry phenomenon producing accelerated heart rates. Symptoms may include palpitations (pulsation in the neck), chest pain, lightheadedness or dizziness, and dyspnea. It is unusual for supraventricular tachycardia to...

American Family Physician : Article

https://www.aafp.org/afp/2010/1015/p942.html

Contemporary Management of Angina: Part I. Risk Assessment - American Family Physician

Dec 1, 1999 - Ischemic heart disease is one of the most common disorders managed by family physicians. Stratifying patients according to risk is important early in the course of the disease to identify patients who require invasive (percutaneous or surgical) treatment. Physical examination, clinical ...

American Family Physician : Article

https://www.aafp.org/afp/1999/1201/p2543.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

Coronary Artery Disease Prevention: What's Different for Women? - American Family ...

Apr 1, 2001 - Cardiovascular disease is the leading cause of death in women, as well as an important cause of disability, although many women and their physicians underestimate the risk. Exercise, hypertension treatment, smoking cessation and aspirin therapy are effective measures for the primary ...

American Family Physician : Article

https://www.aafp.org/afp/2001/0401/p1393.html

Coronary Artery Disease/Coronary Heart Disease - American Family Physician

Nov 1, 2019 - 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

Current Status of Cardiac Rehabilitation - American Family Physician

Nov 15, 1998 - Cardiac rehabilitation is an important management strategy in patients with coronary artery disease. Substantial data from both mortality and morbidity studies support the benefits. Recent studies of patients with coronary artery disease have shown that exercise confers greater benefit ...

American Family Physician : Article

https://www.aafp.org/afp/1998/1115/p1778.html

Dabigatran (Pradaxa) for Prevention of Stroke in Atrial Fibrillation - STEPS - American...

Dec 15, 2011 - Dabigatran is superior to warfarin for stroke prevention in patients with atrial fibrillation, with similar rates of major bleeding. Because it does not require laboratory monitoring, dabigatran therapy is less complicated than warfarin therapy, but it costs significantly more.

American Family Physician : STEPS

https://www.aafp.org/afp/2011/1215/p1397.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

Diagnosing the Cause of Chest Pain - American Family Physician

Nov 15, 2005 - Chest pain presents a diagnostic challenge in outpatient family medicine. Noncardiac causes are common, but it is important not to overlook serious conditions such as an acute coronary syndrome, pulmonary embolism, or pneumonia. In addition to a thorough history and physical ...

American Family Physician : Article

https://www.aafp.org/afp/2005/1115/p2012.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

Diagnosis and Management of Kawasaki Disease - American Family Physician

Mar 15, 2015 - Kawasaki disease is an acute, systemic vasculitis that predominantly affects patients younger than five years. It represents the most prominent cause of acquired coronary artery disease in childhood. In the United States, 19 per 100,000 children younger than five years are hospitalized ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0315/p365.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

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

Diagnosis and Treatment of Sick Sinus Syndrome - American Family Physician

Apr 15, 2003 - Sick sinus syndrome comprises a variety of conditions involving sinus node dysfunction and commonly affects elderly persons. While the syndrome can have many causes, it usually is idiopathic. Patients may experience syncope, pre-syncope, palpitations, or dizziness; however, they often ...

American Family Physician : Article

https://www.aafp.org/afp/2003/0415/p1725.html

Diagnosis and Treatment of Venous Ulcers - American Family Physician

Apr 15, 2010 - Venous ulcer, also known as stasis ulcer, is the most common etiology of lower extremity ulceration, affecting approximately 1 percent of the U.S. population. Possible causes of venous ulcers include inflammatory processes resulting in leukocyte activation, endothelial damage, platelet ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0415/p989.html

Diagnosis of Acute Coronary Syndrome - American Family Physician

Jul 1, 2005 - The term 'acute coronary syndrome' encompasses a range of thrombotic coronary artery diseases, including unstable angina and both ST-segment elevation and non-ST-segment elevation myocardial infarction. Diagnosis requires an electrocardiogram and a careful review for signs and symptoms ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0701/p119.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

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

Diastolic Heart Failure: The Challenges of Diagnosis and Treatment - American Family ...

Jun 1, 2004 - Diastolic heart failure, a major cause of morbidity and mortality, is defined as symptoms of heart failure in a patient with preserved left ventricular function. It is characterized by a stiff left ventricle with decreased compliance and impaired relaxation, which leads to increased end...

American Family Physician : Article

https://www.aafp.org/afp/2004/0601/p2609.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

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

Dietary Fat Modification and the Risk of Future Cardiovascular Events and Mortality - ...

May 1, 2013 - According to the authors of this Cochrane review, reducing or modifying a patient's dietary fat intake did not lower the rates of either total or cardiovascular-related mortality when compared with usual or control diets. Reducing the intake of total or saturated fats decreased the risk...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2013/0501/p609.html

Dietary Fat: Quantity and Quality - Editorials - American Family Physician

Aug 15, 2009 - ...PATRICK E. McBRIDE, MD, MPH, and GAIL UNDERBAKKE, RD, MS, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin Am Fam Physician. 2009 Aug 15;80(4):330-336. Related Article Research has expanded our understanding of the effects of dietary fats on our...

American Family Physician : Editorials

https://www.aafp.org/afp/2009/0815/p330.html

Dietary Therapy for Children with Hypercholesterolemia - American Family Physician

Feb 1, 2000 - Accumulating evidence clearly shows that atherosclerosis begins in youth. The National Cholesterol Education Program (NCEP) has recommended that children at high risk of developing coronary artery disease as adults be screened so that those with elevated low-density lipoprotein (LDL) ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0201/p675.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

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

Does a Low-Sodium Diet Reduce Blood Pressure? - FPIN's Clinical Inquiries - American ...

Jan 15, 2004 - Reducing sodium intake does lead to a slightly lower average blood pressure. However, no evidence from controlled trials proves that reducing sodium intake decreases morbidity or mortality, or proves that modest sodium restriction is harmful.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2004/0115/p359.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

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

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

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

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

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

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

Effective Use of Statins to Prevent Coronary Heart Disease - American Family Physician

Jan 15, 2001 - Primary and secondary prevention trials have shown that use of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (also known as statins) to lower an elevated low-density lipoprotein cholesterol level can substantially reduce coronary events and death from coronary heart ...

American Family Physician : Article

https://www.aafp.org/afp/2001/0115/p309.html

Essentials of the Diagnosis of Heart Failure - American Family Physician

Mar 1, 2000 - Although heart failure is a common clinical syndrome, especially in the elderly, its diagnosis is often missed. A detailed clinical history is crucial and should address not only current signs and symptoms of heart failure but also signs and symptoms that point to a specific cause of ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0301/p1319.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

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

Evaluating Obesity and Cardiovascular Risk Factors in Children and Adolescents - ...

Nov 1, 2008 - Obesity continues to be a growing public health problem. According to the 2003-2004 National Health and Nutrition Examination Survey, 17 percent of persons two to 19 years of age are overweight. The number of obese children and adolescents has tripled in the past 20 years. Obesity in ...

American Family Physician : Article

https://www.aafp.org/afp/2008/1101/p1052.html

Evaluation and Management of Orthostatic Hypotension - American Family Physician

Sep 1, 2011 - Orthostatic hypotension is defined as a decrease in systolic blood pressure of 20 mm Hg or a decrease in diastolic blood pressure of 10 mm Hg within three minutes of standing when compared with blood pressure from the sitting or supine position. It results from an inadequate physiologic...

American Family Physician : Article

https://www.aafp.org/afp/2011/0901/p527.html

Evaluation of Syncope - American Family Physician

Sep 15, 2011 - Syncope is a transient and abrupt loss of consciousness with complete return to preexisting neurologic function. It is classified as neurally mediated (i.e., carotid sinus hypersensitivity, situational, or vasovagal), cardiac, orthostatic, or neurogenic. Older adults are more likely to ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0915/p640.html

Evidence for Global CHD Risk Calculation: Risk Assessment Alone Does Not Change ...

Aug 1, 2010 - To prevent heart attack, stroke, or death, the American Heart Association recommends estimating patients’ absolute risk of having a coronary heart disease (CHD) event in 10 years. Before physicians adopt routine risk calculation, we should use the evidence to determine the best use of ...

American Family Physician : Editorials

https://www.aafp.org/afp/2010/0801/p236.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

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

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

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

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