Journal Wrap

Kim A. Eagle, MD, MACC

The hottest research from various peer-reviewed journals – handpicked weekly by the Editorial Board led by Kim A. Eagle, MD, MACC.

Small BP Reduction, Sizable Impact on CV Event Reduction

A 5 mm Hg reduction in systolic blood pressure (BP) reduced the risk of major cardiovascular disease events by about 10%, irrespective of previous diagnoses of cardiovascular disease, even at normal or high-normal BP values, according to a meta-analysis published in The Lancet.

Researchers evaluated individual participant-level data from 48 randomized trials of BP-lowering medications vs. placebo or other classes of BP-lowering medications, or between more vs. less intensive treatment regimens. Trials exclusively done in heart failure or short-term interventions in acute settings were excluded.

Among the 344,716 participants in the meta-analysis, pre-randomization mean BP was 146/84 mm Hg in participants with previous cardiovascular disease (46%) and 157/89 mm Hg in those without (54%).

After a median 4.15 years, 42,324 participants (12.3%) had at least one major cardiovascular event (stroke 4.0%, ischemic heart disease 5.6%, congestive heart failure 2.4%). In participants without cardiovascular disease at baseline, the incidence rate for developing a major cardiovascular event in the intervention and comparator groups was 25.9 and 31.9 per 1,000 person-years. In those with cardiovascular disease at baseline, these rates were 36.0 and 39.7.

Hazard ratios associated with a reduction of systolic BP by 5 mm Hg for a major cardiovascular event were 0.91 and 0.89 for participants without and with cardiovascular disease at baseline.

These findings suggest a fixed degree of pharmacological BP lowering is similarly effective for primary and secondary prevention of major cardiovascular disease, even at BP levels currently not considered for treatment.

Blood Pressure Lowering Treatment Trialists' Collaboration. Lancet 2021;387:1625-36.

CMR Imaging Increases Detection of Myocarditis in Big Ten Athletes With COVID-19

Using cardiac magnetic resonance (CMR) imaging to screen competitive collegiate athletes with COVID-19 may increase detection of clinical and subclinical myocarditis, according to a study published in JAMA Cardiology.

Study Evaluates Sex-Based Health Disparities Among Premature ASCVD Patients

Unlike their male counterparts, female veterans with premature atherosclerotic cardiovascular disease (ASCVD) receive "less optimal" secondary prevention cardiovascular care, according to a study published in JAMA Cardiology. Comprehensive interventions are crucial towards improving this health care disparity in women.

STS/ACC TVT Registry Study Identifies Hospital Variation in TAVR Care

There are "substantial variations" in the quality of TAVR care delivered at the site level in the U.S., with about 11% of sites providing below-average care, according to a study published in Circulation.

Keywords: ACC Publications, Cardiology Magazine

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