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The use of high-intensity statins after hospitalization for myocardial infarction (MI) increased from 2011 through 2014, reported researchers in the Journal of the American College of Cardiology.
Using data on commercial health insurance from the MarketScan database and Medicare sources, they found that from Jan. through March 2011 to Oct. through Nov. 2014, the percentage of beneficiaries whose first statin prescriptions filled following hospital discharge for MI were for high-intensity doses increased from 33.5% to 71.7% and 24.8% to 57.5%, respectively.
There were also increases in high-intensity statin use following hospital discharge among patients initiating treatment (30.6% to 72.0% in MarketScan and 21.1% to 58.8% in Medicare) and those taking low- or moderate-intensity statins prior to hospitalization (27.8% to 62.3% and 12.6% to 45.1%, respectively).
High-intensity statin use was associated with males and guideline-directed practices such as prescriptions for beta-blockers and anti-platelet drugs, as well as attending cardiac rehabilitation.
"Despite this favorable trend, a substantial percentage of patients filled low- or moderate-intensity statin prescriptions following hospital discharge for MI in 2014. The present study highlights the need to continue efforts to increase high-intensity statin use following hospital discharge for MI," concluded the researchers.
See MedPage Today's full coverage here.
Aging with Healthy Arteries
Although healthy vascular aging is possible for people who live a Western lifestyle, maintaining normal vascular function beyond 70 years of age may be challenging.
In an observational study of more than 3,000 Framingham Study participants, the prevalence of healthy vascular aging, defined as absence of hypertension and pulse wave velocity <7.6 m/s, decreased from 30% among people ages 50 to 59 to 1% among those ages ≥70 years.
Younger age, female sex, lower BMI, use of lipid-lowering drugs, and absence of diabetes mellitus (P<0.001 for all) were cross-sectionally associated with healthy vascular aging, wrote Teemu J. Niiranen and colleagues in Hypertension.
"Our observational data are consistent with the notion that prevention strategies targeting modifiable factors and behaviors included in [the American Heart Association's] Life's Simple 7, and obesity, in particular, may prevent or delay vascular aging and the associated risk of cardiovascular disease," stated Niiranen.
They added that people who achieved six out of seven of the healthy heart goals were 10 times more likely to achieve healthy vascular aging than those who achieved zero to one of the measures. The goals included managing blood pressure, controlling cholesterol, reducing blood sugar, getting active, eating better, losing weight, and stopping smoking.
More Aggressive BP Targets
Lowering the recommended target systolic blood pressure (SBP) level may significantly reduce the risk of cardiovascular disease (CVD) and all-cause mortality for people with hypertension, found a study published in JAMA Cardiology.
While previous U.S. guidelines suggested targets ranging from 140 mm Hg to 150 mm Hg, results from a meta-analysis of 42 randomized clinical trials (144,220 patients) supported a systolic blood pressure target of 120 mm to 124 mm Hg.
When compared with people who achieved a systolic blood pressure of 130 to 134 mm Hg, those who reached the 120 to 124 mm Hg level had a 29% reduction in cardiovascular disease and a 27% reduction in all-cause mortality. The relative risk reductions were even larger in comparisons with groups with higher achieved systolic blood pressure levels, noted the researchers.
The authors concluded that their "findings support more intensive SBP control among adults with hypertension and suggest the need for revising the current clinical guidelines for management of hypertension."
See coverage from Larry Husten, including comment from Yale's Harlan Krumholz, MD, here.
Problematic Internet Use
People who spent a lot of time on the internet experienced significant physiological changes such as increased heart rate and blood pressure when they signed off, reported a team of researchers from Wales and Italy.
Among 144 participants, ages 18 to 33 years, those with digital-behaviour problems saw an average 3-4% increase in heart rate and blood pressure immediately on termination of internet use, compared with before using it, reported Phil Reed, PhD, of Swansea University, and colleagues.
There were no changes for participants who reported no internet-usage problems, they wrote online in PLOS ONE.
"We have known for some time that people who are over-dependent on digital devices report feelings of anxiety when they are stopped from using them, but now we can see that these psychological effects are accompanied by actual physiological changes," stated Reed.
Co-author Lisa Osborne, MD, weighed in, noting that "a problem with experiencing physiological changes like increased heart rate is that they can be misinterpreted as something more physically threatening, especially by those with high levels of anxiety, which can lead to more anxiety, and more need to reduce it."
Reversing Meth-Related Heart Damage
People who abused methamphetamine experienced improvement in symptoms and cardiac function after quitting drugs and receiving medical treatment, reported researchers in JACC: Heart Failure.
Researchers looked at 30 patients -- 93% male -- with evidence of heart failure and history of methamphetamine abuse to assess if heart function improved after discontinuing the drug. All patients received medical treatment including supportive measures and guideline-supported medical therapy.
Patients who discontinued the drug had a lower incidence of death, non-fatal stroke and rehospitalization for heart failure versus those who continued the abuse methamphetamines while on medical therapy, 57% versus 13%, respectively.
"Methamphetamine associated cardiac myopathy will become a growing cause of heart failure in young adults," stated Norman Mangner, MD, of the Heart Center Leipzig in Leipzig, Germany.
"Due to the chance to recover cardiac function and symptoms at an early stage of the disease, early detection of heart problems in patients with methamphetamine abuse could prevent further deterioration of the cardiomyopathy," he continued.
In an accompanying editorial, James L. Januzzi, MD, of Harvard Medical School, wrote that the findings offer objective data showing that cardiac function will only improve after methamphetamine abusers quit using the drugs.
"Rather than simply placing patients with suspected methamphetamine associated cardiomyopathy on a cocktail of neurohormonal blockade, the majority of focus should be on helping such patients quit," he said.