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Medicine by the numbers

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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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Heart Failure - American Family Physician

Jul 1, 2019 - 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

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

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

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

Hyperlipidemia - American Family Physician

May 1, 2019 - This collection features AFP content on hyperlipidemia and related issues, including dyslipidemia, hypercholesterolemia, hypertriglyceridemia, kidney disease, lipid disorders, metabolic syndrome, statins, and triglyceride levels. This collection features AFP content on hyperlipidemia ...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=13

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

Hypertension - American Family Physician

Nov 1, 2019 - This collection features AFP content on hypertension and related issues, including pharmacologic and non-pharmacologic therapies, and blood pressure monitoring and screening. This collection features AFP content on hypertension and related issues, including pharmacologic and ...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=12

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

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

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

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

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

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

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

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

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

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

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 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

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

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

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

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

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

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

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

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

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

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

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

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

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

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