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NIHR Signal The benefits of commonly used blood pressure and cholesterol lowering treatment can last 16 years
Fewer deaths from stroke had occurred in people who had high blood pressure treated with amlodipine, a calcium-channel blocker, compared to atenolol, 10 years after the end of a large trial. People with high blood pressure who took statins were less likely to die from cardiovascular diseases, such as heart disease or stroke than those taking a placebo. This study followed over 7,000 UK patients who had taken part in a clinical trial of blood pressure and cholesterol-lowering treatments between ...
NIHR Signal Home-based cardiac rehabilitation for heart failure has high rates of participation
Home-based cardiac rehabilitation for people with heart failure improves quality of life at 12 months compared with usual care. Among those allocated to rehabilitation, 90% remained in the programme – more than double average attendance rate for hospital-based rehabilitation. The average cost was estimated at £418 per participant which is within the National Health Service tariff for cardiac rehabilitation in England of £477 per patient. This NIHR-funded trial included 216 par...
NIHR Signal People leaving hospital after medical illness do not benefit from extended clot reducing treatment
Taking rivaroxaban after discharge from hospital does not significantly reduce the risk of venous thromboembolism, either blood clots in large veins or of dying from clots travelling to the lungs. People who are hospitalised with conditions such as heart failure and stroke are at an increased risk of blood clots. This risk is further increased by factors such as age, lack of mobility and previous illness or clots. These patients will usually be given anticoagulant treatment to reduce blood clot...
NIHR Signal Aspirin did not prevent deaths or disability in healthy older adults
In the ASPREE trial, older adults with no apparent cardiovascular disease who took daily aspirin saw no benefit in terms of reducing the chance of dying or having dementia or disability. Instead, it slightly increased their mortality and bleeding risk - aspirin was associated with an excess of 1.6 deaths per 1,000 people per year. Half of these deaths were due to cancer. Aspirin is an established ‘secondary’ preventative treatment for people who have known cardiovascular disease. Ho...
NIHR Signal The best dose of aspirin for cardiovascular protection may depend on body weight
Low dose aspirin only appears to be effective at preventing stroke or heart attack for people weighing less than 70kg, while higher doses are better for people who weigh over 70kg. Researchers analysed data from 13 trials of aspirin for primary or secondary prevention of cardiovascular events, totalling over 115,000 participants. They found that 75 to 100mg aspirin only benefitted people who weighed less than 70kg, while only those who weighed 70kg or more benefited from doses of 325mg or above...
NIHR Signal Fish oil supplements do not reduce cardiovascular deaths in people with diabetes without existing vascular disease
Omega-3 fatty acid supplements make no difference to cardiovascular outcomes in people with diabetes but without established cardiovascular disease. Serious vascular events like heart attack, stroke or deaths from these occurred in about 10% of people regardless of whether they took daily omega-3 or placebo capsules for seven years. The ASCEND studyis a large UK trial assessing primary cardiovascular prevention for people with any type of diabetes. A companion publication assesses the use of as...
NIHR Signal New airway device as good as tracheal tube insertion for out-of-hospital resuscitation
A supraglottic airway device works as well as a tracheal tube for paramedics resuscitating patients in cardiac arrest and is simpler to use. People who have stopped breathing need to get air into their lungs urgently. Usually, a tube is placed through the vocal cords into their trachea to secure a reliable airway, but correct placement needs skill and practice and can interrupt chest compressions during resuscitation. More recently, paramedics have used a supraglottic airway device, placed in t...
NIHR Signal The benefits and harms of aspirin for people with type 2 diabetes are finely balanced
Daily aspirin reduced the risk of serious vascular events among people with diabetes, while increasing the risk of major bleeding to a similar extent. Aspirin prevented one person in every 100 from having a heart attack or stroke over seven years, but an additional person per 100 experienced a major bleed. The ASCEND study is one of three large placebo-controlled trials investigating the effects of 100mg daily aspirin for primary prevention in people without established cardiovascular disease. ...
NIHR Signal Routine use of a mechanical compression device is no better than manual chest compression in cardiac arrest
Compared with manual compression, mechanical chest compression does not improve survival rates after cardiac arrest. However, in situations where manual compression may be difficult, such as in a moving ambulance, mechanical compression may still be an option. Each minute that a person waits for treatment after a cardiac arrest can make a difference of up to 10% to their chance of survival. Cardiopulmonary resuscitation (CPR) is the crucial first step to keep oxygen circulating to vital organs ...
NIHR Signal Telemedicine programme can prolong life for heart failure patients
A comprehensive programme of daily telemedicine monitoring and 24-hour access to a physician-led hotline can reduce the number of deaths and the time spent in hospital, among patients with heart failure. A year-long study of 1,571 patients who had been admitted to hospital with heart failure within the past 12 months found that those assigned to daily telemonitoring, monthly health education and telephone support from specialist staff, were 30% less likely to die than those assigned to usual ca...
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