Cardiovascular Daily wraps up the top cardiology news of the week
Major bleeding is a big concern with the antithrombotic medications used for people with cardiovascular disease, but it also may occur more often than thought in patients with no obvious triggers, according to a large primary care cohort study from New Zealand.
A first major bleeding event leading to death or hospitalization occurred among 1.1% of people ages 30 to 79 during a median follow-up of 2.8 years. That risk dipped slightly to 0.9% among both lower-risk individuals without medical conditions associated with increased bleeding and those not taking medications that increase bleeding risk.
GI bleeding made up more than 70% of the bleeding events, the researchers noted in the Journal of the American Medical Association.
See the rest of the story on MedPage Today.
Early Binge Drinking
Heavy drinking episodes in young adulthood may pose a heart risk, researchers reported in the Journal of the American Heart Association.
In a study of 18- to 45-year-olds using National Health and Nutrition Examination Survey data, binge drinking was associated with higher systolic blood pressure and higher blood total cholesterol in men but not women. The results were independent of diet and physical activity.
In a separate meta-analysis not stratified by age, men had higher hypertension risk with any level of daily drinking versus none, with a risk that rose by number of daily drinks. For women, a drink or two a day wasn't associated with risk but higher levels were.
Together the findings support a message that "the drinking habits we adopt in early adulthood and middle-age (a time when we are typically free from disease) correlate with premorbid indicators of cardiovascular health," an accompanying editorial concluded. But, it cautioned, messages about alcohol are complex and cannot be one-size-fits-all.
Nature and Nurture
Genetics and health behaviors and factors have a "log-additive effect" on cardiovascular disease risk, a U.K. Biobank cohort study showed in JAMA Cardiology.
"Genetic risk and lifestyle were independent predictors of incident events, and there were no interactions for any outcome," the researchers reported, calling for lifestyle improvements to be encouraged for all, with special attention to those at high genetic risk.
Compared with ideal lifestyle in the low genetic risk group, poor lifestyle in high genetic risk people was associated with four to five-fold higher risk of coronary artery disease, atrial fibrillation, and hypertension, twofold risk of stroke, and more than 15-fold diabetes risk.
Two studies out of the American Diabetes Association meeting in Orlando had good news for heart risks.
In a randomized trial among type 1 diabetes patients, adding the GLP-1 analog liraglutide (Victoza) to conventional insulin treatment improved glycemic control but also yielded a 2.5 kg (5.5 lb) placebo-adjusted weight loss and 9 mm Hg reduction in systolic blood.
In real-world data from the CVD-REAL 2 study in type 2 diabetes, starting on an SGLT-2 inhibitor was associated with not only lower mortality but fewer strokes, heart attacks, and heart failure hospitalizations as well.
MedPage Today has the full story on these in the links above.
In Other News
The Centers for Medicare and Medicaid Services opened up public comments ahead of next month's panel meeting to look at revamping volume requirements for coverage of transcatheter aortic valve replacement. MedPage Today has the full story here.
Read the original article on Medpage Today: Binge Drinking; Bleeds Off-Drug; Nature and Nurture Gang Up On CVD Risk