Evidence
Alert

Smoking bans improve cardiovascular health and reduce smoking-related deaths

This review strengthens the evidence that legislative smoking bans lead to improved health outcomes for people through the reduction of secondhand smoke. The evidence was strongest for improving cardiovascular health outcomes (such as reduced rates of heart attack) and reducing smoking-related deaths. Effects on respiratory and perinatal health were less consistent. The review was an ...

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Annual lipid monitoring places more individuals in treatment and saves money long-term compared with less frequent monitoring

Annual testing to monitor blood lipids (fat and cholesterol) was both effective and saved money long term in by reducing cardiovascular disease in people with or without known heart disease. Given the relatively low cost of treating high lipids (typically by using statins) it was more cost effective to over-treat people than to under-treat them. ...

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Lowering blood pressure reduces the risk of heart disease, stroke and death

This meta-analysis showed that a 10 mm Hg reduction of systolic blood pressure reduced the risk of major cardiovascular disease events by 20%, coronary heart disease by 17%, stroke by 27%, heart failure by 28%, and death from all causes by 13%. This study strongly supports offering drug treatments to reduce systolic blood pressure levels ...

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Specialist nurses can manage heart failure drug dosing successfully

Use of specialist nurses to optimise drug dosages using protocols in people with heart failure was more effective than dose monitoring by other health professionals. These nurses had advanced practice certification. This finding came from a review of seven trials with more than 1600 patients. International guidelines recommend two or three first-line medications for people ...

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Continuous positive airway pressure treatment for obstructive sleep apnoea linked to fewer recurrences of heart rhythm abnormalities

Treating a common sleep-related breathing condition almost halved the chance of recurrent atrial fibrillation (AF, see Definitions). However, most of the included studies were observational. This makes it difficult to rule out the possibility of bias in choosing which patients to treat and therefore reduces our confidence in the size of this effect. The breathing ...

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Telehealth can help people with heart failure avoid hospital admission

Home telephone or telemonitoring support can bring some aspects of specialised care and monitoring into the homes of people with heart failure. This updated Cochrane review confirmed that people with heart failure who received home telehealth support were less likely to die or go into hospital for problems relating to their heart failure than those ...

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Large trial finds no benefit from restricting limb blood supply before heart surgery

Early small studies suggested that a period of restriction of blood supply to the arm just before cardiac surgery might confer some protection to the heart during surgery (please see ‘A review of restricting blood supply to a limb before heart surgery highlights the need for better evidence’). The NIHR funded this large, multi-centre trial ...

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A review of restricting blood supply to a limb before heart surgery highlights the need for better evidence

This review of trials looked at a procedure that restricts blood supply to a limb just before heart surgery, which might prepare the heart for reduced blood flow during surgery. The technique was tested alongside the use of inhaled or injected anaesthetic. The review of 55 trials found the technique in combination with inhaled anaesthetic ...

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Breathing training before major surgery may reduce lung complications afterwards

This review found that physiotherapist-led training in breathing before heart or major abdominal surgery was associated with a reduced risk of lung collapse or pneumonia after surgery. There was no evidence that it reduced the numbers of people ventilated for 48 hours or more, or the chance of death after the operation. Post-operative lung complications ...

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Home oxygen therapy prescribed for 15 hours a day did not reduce breathlessness at six months and is hard to take for people with severe chronic heart failure

This NIHR-funded trial found no evidence that long-term home oxygen therapy improves symptoms or quality of life for people with severe chronic heart failure. There were encouraging signs after three months but these were not sustained at six months by which time there was no difference between the oxygen therapy group, who continued to receive ...

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