December 2018 Briefing - Cardiology

Here are what the editors at HealthDay consider to be the most important developments in Cardiology for December 2018. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Catheter Ablation Tops Drug Therapy for A-Fib in Heart Failure

MONDAY, Dec. 31, 2018 -- Catheter ablation is better than drug therapy for the treatment of atrial fibrillation (AF) in patients with heart failure, according to a review published online Dec. 25 in the Annals of Internal Medicine.

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ACOG Updates Guidelines for Gestational HTN, Preeclampsia

FRIDAY, Dec. 28, 2018 -- The American College of Obstetricians & Gynecologists (ACOG) has updated its guidance on the management of gestational hypertension and preeclampsia as well as chronic hypertension in pregnant women; the two practice bulletins were published in the January issue of Obstetrics & Gynecology.

High Sodium Intake Associated With New Atrial Fibrillation

FRIDAY, Dec. 28, 2018 -- Sodium intake is associated with the long-term risk of new-onset atrial fibrillation (AF), according to a study recently published in the Annals of Medicine.

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Second-Line Antidiabetic Meds May Impact Cardiovascular Risk

FRIDAY, Dec. 28, 2018 -- For adults with type 2 diabetes initiating second-line antidiabetic medications (ADM), cardiovascular risk is increased with use of sulfonylureas or basal insulin versus newer ADM classes, according to a study published online Dec. 21 in JAMA Network Open.

Having Children Tied to Higher Risk for Cardiovascular Disease

FRIDAY, Dec. 28, 2018 -- Parity is associated with cardiovascular disease risk, with a nonlinear J-shaped dose-response relationship observed, according to a meta-analysis published online Dec. 19 in the European Journal of Preventive Cardiology.

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Low-Priced Generic Drugs Most Likely to Have Shortages

THURSDAY, Dec. 27, 2018 -- The lowest-priced generic drugs are more likely to experience shortages, according to a study published in the November issue of Value in Health.

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30-Day Postdischarge Mortality Up With HRRP Implementation

THURSDAY, Dec. 27, 2018 -- Announcement and implementation of the Hospital Readmissions Reduction Program (HRRP) were associated with increased 30-day postdischarge mortality following hospitalization for heart failure and pneumonia, but not acute myocardial infarction (AMI), according to a study published in the Dec. 25 issue of the Journal of the American Medical Association.

New BP Treatment Cutoffs May Not Yield Survival Benefit

THURSDAY, Dec. 27, 2018 -- New blood pressure treatment recommendations may not improve survival from cardiovascular disease (CVD), according to a study recently published in the European Heart Journal.

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ASH Develops Practice Guidelines for Venous Thromboembolism

THURSDAY, Dec. 27, 2018 -- The American Society of Hematology (ASH) has developed new guidelines for the treatment of venous thromboembolism (VTE); the clinical practice guidelines were recently published in Blood Advances.

Complications, Costs Up With Cardiac Sx in Opioid Use Disorder

WEDNESDAY, Dec. 26, 2018 -- Patients with opioid use disorder (OUD) undergoing cardiac surgery have increased complications and costs, according to a study published online Dec. 5 in JAMA Surgery.

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Initiative Can Cut Gender Gap in Medical School Faculty Salaries

WEDNESDAY, Dec. 26, 2018 -- An institutional gender equity initiative (GEI) can reduce gender-based salary gaps among medical school faculty, according to a study published online Dec. 21 in JAMA Network Open.

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New AAP Guideline Available for Infantile Hemangioma Treatment

WEDNESDAY, Dec. 26, 2018 -- The American Academy of Pediatrics has developed its first guideline for the management of infantile hemangiomas (IHs); the clinical practice guideline was published online Dec. 24 in Pediatrics.

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Risk of Arterial Thromboembolic Events Up Prior to Cancer Diagnosis

WEDNESDAY, Dec. 26, 2018 -- In older adults, the risk of arterial thromboembolic events begins to increase 150 days before the date of cancer diagnosis and peaks 30 days before, according to a study published online Dec. 21 in Blood.

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Drug Use-Associated Infective Endocarditis Up 2007 to 2017

WEDNESDAY, Dec. 26, 2018 -- From 2007 to 2017 there was an increase in drug-use associated infective endocarditis (DUA-IE) hospitalizations and valve surgeries, according to a study published online Dec. 4 in the Annals of Internal Medicine.

ACOG: Interpregnancy Period Should Maximize Women's Health

WEDNESDAY, Dec. 26, 2018 -- Providers should maximize women's health during the interpregnancy period, continuing care beyond the immediate postpartum period, according to a consensus report published online Dec. 20 in the American Journal of Obstetrics & Gynecology.

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EMS Treatment for Possible Heart Attack Varies by Sex

MONDAY, Dec. 24, 2018 -- Disparities exist in the emergency medical services (EMS) treatment of women and men with chest pain (CP) or out-of-hospital cardiac arrest (OHCA), according to a study published online Dec. 10 in Women's Health Issues.

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FDA Warns Companies on Unsafe, Unapproved Stem Cell Treatments

FRIDAY, Dec. 21, 2018 -- After infections tied to unapproved stem cell treatments sent 12 people to the hospital this past year, the U.S. Food and Drug Administration has issued a stern warning about the products.

FDA: Fluoroquinolones Tied to Heart Vessel Ruptures, Tears

FRIDAY, Dec. 21, 2016 -- Patients taking fluoroquinolones may be at higher risk for ruptures or tears in the aorta, the U.S. Food and Drug Administration warns.

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CDC: Weight, Waist Size, BMI Increased for Many U.S. Adults

FRIDAY, Dec. 21, 2018 -- From 1999-2000 to 2015-2016, there was an increase in mean weight, waist circumference, and body mass index (BMI) for many U.S. adults, according to the Dec. 20 issue of the National Vital Statistics Reports, a publication from the U.S. Centers for Disease Control and Prevention.

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A-Fib Risk Up for Antidepressant Users, but Higher Before Tx

FRIDAY, Dec. 21, 2018 -- The risk for atrial fibrillation (AF) is increased among antidepressant users, particularly before treatment initiation, according to a study recently published in the European Journal of Preventive Cardiology.

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Endurance Exercise Tied to Anti-Aging at Cellular Level

FRIDAY, Dec. 21, 2018 -- Endurance exercise has anti-aging effects visible at the cellular level, according to a study published online Nov. 28 in the European Heart Journal.

Racial Disparities Seen in Use of Oral Anticoagulants for A-Fib

THURSDAY, Dec. 20, 2018 -- Black patients with atrial fibrillation are less likely to receive direct-acting oral anticoagulants (DOACs) compared with white patients, even after controlling for clinical and sociodemographic features, according to a study published in the December issue of JAMA Cardiology.

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Growth in Use of Telemedicine Seen From 2005 to 2017

THURSDAY, Dec. 20, 2018 -- From 2005 to 2017, there was a substantial increase in telemedicine use, although use was still uncommon in 2017, according to a research letter published online Nov. 27 in the Journal of the American Medical Association.

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Affordable Care Act Sign-Ups Higher Than Expected

THURSDAY, Dec. 20, 2018 -- Despite numerous difficulties, early figures show that sign-ups for health coverage next year under the Affordable Care Act are higher than expected.

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Hospitalization for Upper GI Bleed Highest With Rivaroxaban

THURSDAY, Dec. 20, 2018 -- For patients initiating oral anticoagulant therapy, the incidence of hospitalization for upper gastrointestinal bleeding is highest and lowest with rivaroxaban and apixaban, respectively, according to a study published in the Dec. 4 issue of the Journal of the American Medical Association.

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Exposure to Metals, Pesticides Tied to CVD in Hispanics/Latinos

THURSDAY, Dec. 20, 2018 -- Occupational exposures to pesticides and metals are associated with an increased prevalence of cardiovascular disease (CVD) among Hispanics/Latinos, according to a study published online Dec. 11 in Heart.

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Global Lifetime Risk for Stroke About 25 Percent in 2016

THURSDAY, Dec. 20, 2018 -- The global lifetime risk for stroke was 24.9 percent among adults aged 25 years and older in 2016, according to a study published in the Dec. 20 issue of the New England Journal of Medicine.

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ADA 2019 Standards of Care Emphasize Patient-Centered Care

THURSDAY, Dec. 20, 2018 -- Patient-centered care is emphasized in updated clinical practice recommendations from the American Diabetes Association 2019 Standards of Care, published as a supplement to the January issue of Diabetes Care.

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Residential Greenness Linked to Cardiovascular Disease Risk

WEDNESDAY, Dec. 19, 2018 -- The density of greenness near residences is associated with lower urinary levels of epinephrine and F2-isoprostane, according to a study published in the Dec. 18 issue of the Journal of the American Heart Association.

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Edentulism Tied to Greater Risk for High BP After Menopause

WEDNESDAY, Dec. 19, 2018 -- Postmenopausal women with edentulism are at an increased risk for developing hypertension, according to a study published online Dec. 4 in the American Journal of Hypertension.

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High Sodium May Contribute to CVD Deaths in Shandong, China

WEDNESDAY, Dec. 19, 2018 -- A considerable proportion of cardiovascular disease (CVD) deaths in Shandong Province, China, may be attributable to high sodium intake, according to a study published online Dec. 19 in the Journal of the American Heart Association.

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Hospitalizations Up for Homeless From 2007 to 2013

TUESDAY, Dec. 18, 2018 -- From 2007 to 2013, hospitalizations among homeless individuals increased and were most frequently for mental illness and substance use disorder, according to a study published in the January issue of Medical Care.

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Cognitive Decline Similar After Cardiac Surgery, Catheterization

TUESDAY, Dec. 18, 2018 -- For older adults, declines in memory after heart surgery and cardiac catheterization are similar, according to a study published online Dec. 18 in the Annals of Thoracic Surgery.

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Appropriate Use Criteria Released for Peripheral Artery Intervention

TUESDAY, Dec. 18, 2018 -- Appropriate use criteria have been developed for peripheral artery intervention (PAI) in peripheral artery disease, according to a report published online Dec. 17 in the Journal of the American College of Cardiology.

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Exclusion of Doctors From Public Health Insurance Up 2007 to 2017

TUESDAY, Dec. 18, 2018 -- From 2007 to 2017, the number of physicians excluded from Medicare and state public insurance programs increased, according to a study published online Dec. 14 in JAMA Network Open.

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EHR Data ID Differences in HTN Control Across Health Systems

TUESDAY, Dec. 18, 2018 -- An analysis of electronic health record data reveals considerable differences in hypertension control across health systems, according to a study published in the November-December issue of the Journal of the American Board of Family Medicine.

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Follow-Up Within Seven Days of Heart Failure Discharge Beneficial

MONDAY, Dec. 17, 2018 -- For patients with heart failure, follow-up care within seven days of discharge from the emergency department is associated with lower rates of long-term mortality and subsequent admissions, according to a study published in the Dec. 17 issue of CMAJ, the journal of the Canadian Medical Association.

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Adherence and Intensity of Lipid-Lowering Tx Influence CV Risk

MONDAY, Dec. 17, 2018 -- Adherent patients receiving high-intensity statin and/or ezetimibe therapy have the lowest cardiovascular risk, according to a study published online Dec. 7 in JAMA Network Open.

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Barbershop Intervention Leads to Reduced BP in Black Men

MONDAY, Dec. 17, 2018 -- A barbershop-based intervention can lead to significantly reduced blood pressure and sustained improvements over one year in black men, according to a study published online Dec. 17 in Circulation.

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Emotional Stress of Holidays Can Trigger Heart Attacks

FRIDAY, Dec. 14, 2018 -- The highest risk for myocardial infarction occurs around 10 p.m. on Christmas Eve, according to a study published online Dec. 12 in The BMJ.

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Apixaban Prevents VTE in Cancer Patients Initiating Chemotherapy

FRIDAY, Dec. 14, 2018 -- Among patients with cancer starting chemotherapy who are at intermediate-to-high risk, rates of venous thromboembolism are significantly lower for thromboprophylaxis with apixaban versus placebo, according to a study published online Dec. 4 in the New England Journal of Medicine.

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Persistent Discrimination ID'd Among Physician Mothers

FRIDAY, Dec. 14, 2018 -- Physician mothers experience discrimination in a range of ways, which can impact the medical profession, according to a study published online Dec. 12 in The BMJ.

Pregnancy Losses Linked to Risk for Cardiovascular Disease

THURSDAY, Dec. 13, 2018 -- Both pregnancy losses and a history of at least five live births are associated with an increased risk for cardiovascular disease, according to a study published online Nov. 27 in the Journal of Women's Health.

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Medication Errors Resulting in Death Most Common in Elderly

THURSDAY, Dec. 13, 2018 -- Medication errors in acute care that result in death occur most often in patients older than 75 years, with the most common error category being omitted medicine or ingredient, according to a study published online Nov. 22 in Research in Social and Administrative Pharmacy.

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Risk for Hospitalization for Heart Failure Greater With Diabetes

THURSDAY, Dec. 13, 2018 -- Despite declining incidence, heart failure hospitalization is increased among individuals with diabetes, according to a study published in the Dec. 11 issue of Circulation.

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Enrollment Under the Affordable Care Act Down From Last Year

WEDNESDAY, Dec. 12, 2018 -- Enrollment for health insurance under the Affordable Care Act is down with just days left to sign up, according to the U.S. Centers for Medicare & Medicaid Services.

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FDA: Some E-Cigarette Liquids Contain Erectile Dysfunction Meds

WEDNESDAY, Dec. 12, 2018 -- Consumers should not use two electronic cigarette liquids that contain erectile dysfunction drugs because they may pose health risks, according to the U.S. Food and Drug Administration.

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2017 Saw Slowing in National Health Care Spending

WEDNESDAY, Dec. 12, 2018 -- National health care spending slowed in 2017, according to a report published online Dec. 6 in Health Affairs.

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Greater Patient Delays for Women With STEMI Than Men

WEDNESDAY, Dec. 12, 2018 -- Because of greater patient delays from symptom onset to first medical contact, female patients with ST-segment elevation myocardial infarction (STEMI) experience greater total ischemic time than male patients, according to a study recently published in the European Heart Journal: Acute Cardiovascular Care.

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Paid Childbearing Policies Lacking for Residents

TUESDAY, Dec. 11, 2018 -- Policies for paid childbearing or family leave for residents are lacking at top-ranking medical schools and may be exacerbated by lack of direction from specialty boards, according to two research letters published in the Dec. 11 issue of the Journal of the American Medical Association.

U.S. Medical Schools See Increase in Diversity

TUESDAY, Dec. 11, 2018 -- After implementation of the Liaison Committee on Medical Education (LCME) diversity accreditation standards, U.S. medical schools saw increasing percentages of female, black, and Hispanic matriculants, according to a research letter published in the Dec. 4 issue of the Journal of the American Medical Association.

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Consensus Decision Pathway Developed for Tobacco Cessation

TUESDAY, Dec. 11, 2018 -- An expert consensus decision pathway has been developed for tobacco cessation treatment; the report was published online Dec. 5 in the Journal of the American College of Cardiology.

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Flu Vaccine Linked to Reduced Risk for Death in Heart Failure

TUESDAY, Dec. 11, 2018 -- After extensive adjustment for confounders, influenza vaccination is associated with a reduced risk for all-cause and cardiovascular death among patients with heart failure, according to a study published online Dec. 10 in Circulation.

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HIT-Related Stress Linked to Burnout Among Physicians

MONDAY, Dec. 10, 2018 -- Stress related to use of health information technology (HIT) is common and predictive of burnout among physicians, according to a study published online Dec. 5 in the Journal of the American Medical Informatics Association.

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Veterans Health Administration Hospitals Outperform Non-VHAs

MONDAY, Dec. 10, 2018 -- Veterans Health Administration (VHA) hospitals outperform non-VHA hospitals for 14 of 15 outcome measures in 121 regions, according to a research letter published online Dec. 11 in the Annals of Internal Medicine.

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Survival Similar With Donor Hearts From Hepatitis C+ Donors

MONDAY, Dec. 10, 2018 -- Transplant patients with hearts from donors with hepatitis C virus (HCV) infection and obese donors have similar survival rates as patients with other donor hearts, according to two studies published in the December issue and online Dec. 4 in Circulation: Heart Failure and the Journal of the American Heart Association, respectively.

AHA Scientific Statement: Low Risk of Side Effects for Statins

MONDAY, Dec. 10, 2018 -- Statins are associated with a low risk for side effects, according to a scientific statement from the American Heart Association (AHA) published online Dec. 10 in Arteriosclerosis, Thrombosis and Vascular Biology.

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EMS Times Longer for Patients From Poorest Neighborhoods

MONDAY, Dec. 10, 2018 -- Patients with cardiac arrest from the poorest neighborhoods have longer emergency medical service (EMS) times, according to a study published online Nov. 30 in JAMA Network Open.

Less Than One Hour of Resistance Training Weekly Tied to Lower CVD Risk

MONDAY, Dec. 10, 2018 -- Less than an hour a week of resistance exercise (RE) is associated with decreased risks for cardiovascular disease (CVD)-related events and all-cause mortality, independent of aerobic exercise, according to a study recently published in Medicine & Science in Sports & Exercise.

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Most Insured Patients Not Using Online Portals

FRIDAY, Dec. 7, 2018 -- Nearly two-thirds of insured adults with a previous health care visit did not use an online patient portal in 2017, according to a study published in the December issue of Health Affairs.

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Botox Injections Explored to Cut Postop A-Fib in Cardiac Surgery

FRIDAY, Dec. 7, 2018 -- Intraoperative botulinum toxin (BTX) injections show promise as a way to reduce the risk for postoperative atrial fibrillation (AF) following cardiac surgery, according to two studies recently published in Heart Rhythm.

Patient Education Can Improve Chronic Disease Management

FRIDAY, Dec. 7, 2018 -- An educational intervention can improve patients' ability to self-manage their chronic diseases, according to a study published in the November issue of the Journal of the American Osteopathic Association.

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Meds Taken Do Not Vary With ADL Impairment in Heart Failure

FRIDAY, Dec. 7, 2018 -- For individuals with heart failure, those with impairment in activities of daily living (ADL) take as many medications as those without ADL impairment, according to a study published online Nov. 29 in the Journal of the American Geriatrics Society.

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Pictorial Presentation of Silent Atherosclerosis Helps Cut CV Risk

THURSDAY, Dec. 6, 2018 -- Pictorial presentation of silent atherosclerosis contributes to the prevention of cardiovascular disease, according to a study published online Dec. 3 in The Lancet.

J-Shaped Association for Sleep Duration, CV Events and Death

WEDNESDAY, Dec. 5, 2018 -- There is a J-shaped association for total daily sleep duration with all-cause mortality and cardiovascular events, according to a study published online Dec. 5 in the European Heart Journal.

FDA Warns of Rare Stroke Risk With Multiple Sclerosis Drug

WEDNESDAY, Dec. 5, 2018 -- A new warning has been added to the multiple sclerosis drug Lemtrada (alemtuzumab) after rare reports of patients suffering strokes and tears in the lining of the arteries in the head and neck, the U.S. Food and Drug Administration said.

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Skin Autofluorescence Predicts T2DM, Heart Disease, Mortality

WEDNESDAY, Dec. 5, 2018 -- Skin autofluorescence predicts incident type 2 diabetes, cardiovascular disease (CVD), and mortality in the general population, according to a study published online Nov. 21 in Diabetologia.

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Few Physicians Work in Practices That Use Telemedicine

WEDNESDAY, Dec. 5, 2018 -- Only 15.4 percent of physicians work in practices that use telemedicine for a wide spectrum of patient interactions, with larger practice size being an important correlate of telemedicine use, according to a study published in the December issue of Health Affairs.

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Migraine With Aura Linked to Increase in Incident A-Fib

WEDNESDAY, Dec. 5, 2018 -- Migraine with aura is associated with an elevated risk for incident atrial fibrillation (AF), according to a study published online Nov. 14 in Neurology.

Many Patients Withhold Information From Clinicians

TUESDAY, Dec. 4, 2018 -- Many patients intentionally withhold information from clinicians, according to a study published online Nov. 30 in JAMA Network Open.

HHS Issues Draft Strategy for Reducing Health IT Burden

TUESDAY, Dec. 4, 2018 -- The U.S. Department of Health and Human Services has developed a draft strategy to reduce the health information technology (IT) burden, and the strategy is open for public comment through Jan. 28, 2019.

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Marathon Runners Show Markers of Cardiac Strain

TUESDAY, Dec. 4, 2018 -- Running a marathon can increase cardiac strain in amateur runners, according to a research letter published online Dec. 3 in Circulation.

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Urate Elevation in Potential Tx for Parkinson's Not Tied to HTN

TUESDAY, Dec. 4, 2018 -- There is no correlation between urate and blood pressure (BP) in mice or among patients with early Parkinson's disease (PD), according to a study published in the November issue of EBioMedicine.

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Younger Patients Account for Increasing Proportion of AMI

TUESDAY, Dec. 4, 2018 -- The proportion of hospitalizations for acute myocardial infarction attributable to young patients increased between 1995 and 2014, especially among women, according to a study published online Nov. 11 in Circulation.

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New BP Goals Could Prevent 3 Million CVD Events Over 10 Years

MONDAY, Dec. 3, 2018 -- Achieving and maintaining 2017 American College of Cardiology/American Heart Association (ACC/AHA) blood pressure (BP) goals could prevent a greater number of cardiovascular disease (CVD) events than achieving prior U.S. guideline goals, according to a study published online Nov. 19 in Circulation.

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Posted: January 2019