Abstract:
:The use of preventive medications in people at high risk of cardiovascular disease is conceptually straightforward, yet in practice the adoption of such measures is disappointingly low, plus there is wide international variation in preventive therapies. Several barriers might explain this shortfall and variation, but the simplicity and economy of a polypill-based strategy might overcome some barriers. The 'Use of a Multidrug Pill In Reducing cardiovascular Events' (UMPIRE) trial assesses whether a polypill strategy (by combining aspirin, a statin and two blood pressure lowering agents) would improve adherence to guideline-indicated therapies and would lower both blood pressure and cholesterol, in people with established cardiovascular disease. UMPIRE, running in India and three European countries (England, Ireland and the Netherlands), is an open, randomised, controlled trial designed to include 1000 participants in India and 1000 in Europe, with a followup of 12-24 months. Participants were randomised to one of two versions of the polypill or relegated to usual care. The primary study outcomes were the self-reported use of aspirin, a statin and at least two blood pressure lowering agents; as well as changes in blood pressure and cholesterol. Secondary outcomes included: any cardiovascular events, reasons for stopping medications, serious adverse events and perceived changes in quality of life. Interpretation of the study data will be enhanced by health, economic and process-related evaluations. UMPIRE is registered with the European Clinical Trials database, as EudraCT: 2009-016278-34 and the Clinical Trials Registry, India as CTRI/2010/091/000250. The trial was part of the 'Single Pill Against Cardiovascular Events (SPACE)' collaboration, which encompasses the 'IMProving Adherence using Combination Therapy (IMPACT)' and 'Kanyini Guidelines Adherence with the Polypill (Kanyini-GAP)' trials.
journal_name
Eur J Prev Cardioljournal_title
European journal of preventive cardiologyauthors
Thom S,Field J,Poulter N,Patel A,Prabhakaran D,Stanton A,Grobbee DE,Bots ML,Reddy KS,Cidambi R,Rodgers Adoi
10.1177/2047487312463278subject
Has Abstractpub_date
2014-02-01 00:00:00pages
252-61issue
2eissn
2047-4873issn
2047-4881pii
2047487312463278journal_volume
21pub_type
杂志文章,多中心研究,随机对照试验abstract::Demographic changes, progress in medicine technology and regional problems in providing healthcare to low density populations are posing great challenges to our healthcare systems. Rapid progress in computer sciences and information technologies have a great impact on the way healthcare will be delivered in the near f...
journal_title:European journal of preventive cardiology
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doi:10.1177/2047487316670256
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abstract:BACKGROUND:Several selected population-based studies have emphasized the significance of resting heart rate as an independent cardiovascular risk factor. However, there are no data available for using resting heart rate as a cardiovascular risk predictor in contemporary primary care. Thus, the aim of our analysis was t...
journal_title:European journal of preventive cardiology
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doi:10.1177/1741826710394304
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abstract::Patients with type 2 diabetes mellitus suffer from dysregulation of a plethora of cardiovascular and metabolic functions, including dysglycaemia, dyslipidaemia, arterial hypertension, obesity and a reduced cardiorespiratory fitness. Exercise training has the potential to improve many of these functions, such as insuli...
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abstract::Atrial fibrillation is the most common sustained arrhythmia in hypertrophic cardiomyopathy (HCM), occurring in approximately 25% of patients, which is four to six times more common than in similarly aged patients of the general population. Atrial fibrillation is poorly tolerated by HCM patients, largely due to their d...
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abstract:BACKGROUND:Exercise oscillatory ventilation is an ominous outcome sign in heart failure due to reduced left ventricular ejection fraction; currently, the prevalence of exercise oscillatory ventilation is unknown in left ventricular assist device recipients. METHODS:We studied cardiopulmonary exercise testing in heart ...
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abstract::Using data from the Seven Countries Study of Cardiovascular Diseases, the first study to conduct international comparisons of men in different European, USA, and Japanese cohorts, we examined the effect of diet-associated inflammation on prediction of coronary heart disease-, other major cardiovascular disease- and al...
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abstract:AIMS:Cardiovascular health metrics predict the risk not only of cardiovascular diseases but also of several types of cancers. Microvascular endothelial dysfunction can predict future cardiovascular adverse events, but the predictive value of microvascular endothelial dysfunction for future risk of solid-tumor cancer ha...
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abstract::Background Insomnia symptoms have been suggested to be associated with the risk of cardio-cerebral events. However, the results of previous studies have been inconsistent. Therefore, we conducted a meta-analysis to examine whether there were associations between cardio-cerebral vascular events and insomnia symptoms, i...
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abstract:BACKGROUND:There is strong evidence to suggest that social deprivation is linked to health inequalities. In the UK, concerns have been raised regarding disparities in the outcomes of acute cardiac services within the National Health Service (NHS). This study explored whether differences exist in (a) elective hospital p...
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abstract:BACKGROUND:The effects of increasing high-density lipoprotein cholesterol on cardiovascular outcomes remain uncertain. DESIGN:We conducted a meta-analysis to investigate the effects of high-density lipoprotein cholesterol modifiers (niacin, fibrates and cholesteryl ester transfer protein inhibitors) on cardiovascular ...
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abstract:BACKGROUND:While cardiorespiratory fitness is strongly related to survival, there are limited data regarding musculoskeletal fitness indicators. Our aim was to evaluate the association between the ability to sit and rise from the floor and all-cause mortality. DESIGN:Retrospective cohort. METHODS:2002 adults aged 51-...
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abstract:BACKGROUND:Obesity and physical inactivity in children correlate with the presence of cardiovascular risk factors. The aim of this prospective, randomised, interventional study was to examine the long term impact of additional physical exercise lessons at school on fitness and cardiovascular risk factors. METHODS:We r...
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pub_type: 杂志文章,多中心研究,随机对照试验
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abstract::Background Preliminary evidence suggests that peak exercise oxygen pulse - peak oxygen uptake/heart rate-, a variable obtained during maximal cardiopulmonary exercise testing and a surrogate of stroke volume, is a predictor of mortality. We aimed to assess the associations of peak exercise oxygen pulse with sudden car...
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abstract:BACKGROUND:The Comparison of Sacubitril-Valsartan versus Enalapril on Effect on NT-proBNP in Patients Stabilised from an Acute Heart Failure Episode (PIONEER-HF) trial demonstrated significant reductions in N-terminal pro-B-type natriuretic peptide. Our study explored the cost-effectiveness of the use of sacubitril-val...
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abstract:BACKGROUND:In order to improve national cardiovascular disease (CVD) epidemiology and prevention, we systematically reviewed and analyzed the relevant literature produced in the last three decades for Spain. DESIGN:Systematic Review. METHODS:We searched for all the articles aiming to monitor CVD clinical endpoints an...
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abstract:AIMS:To determine the effect of ticagrelor compared to clopidogrel in patients with peripheral artery disease (PAD) and acute coronary syndromes (ACS). METHODS AND RESULTS:PLATO (n = 18,624) was a multicentre, double-blind, randomized trial in ACS, that showed a 16% reduction in cardiovascular death (CV-death), myocar...
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abstract::Background Inverse associations of the Mediterranean diet (MedDiet) and physical activity with cardiovascular disease have been previously reported. We investigated the individual and combined contributions of both to this inverse association in a Mediterranean cohort. Design We used data from 19,536 participants from...
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abstract:BACKGROUND:Exercise training is a non-pharmacological strategy for treatment of heart failure. Exercise training improves functional capacity and quality of life in patients. Moreover, exercise training reduces muscle sympathetic nerve activity (MSNA) and peripheral vasoconstriction. However, most of these studies have...
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abstract:AIM:We aimed to clarify the strength of the association between conventional and metabolic risk factors to coronary heart disease (CHD) mortality across short, intermediate, and long periods of follow-up and whether the effects of risk factors are heterogeneous across serum cholesterol levels. METHODS:The Oslo Study p...
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abstract:BACKGROUND:Blood pressure (BP) variations occurring after hospital discharge in a population of older hypertensives have not been previously investigated. DESIGN:elderly (≥65 years) hypertensives admitted to the geriatric acute ward of a university-teaching hospital were enrolled in this prospective observational stud...
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pub_type: 杂志文章,评审
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abstract:AIMS:Air pollution and noise are potential risk factors for subclinical atherosclerosis. Longitudinal analyses, especially on the interplay of these environmental factors, are scarce and inconsistent. Hence we investigated long-term traffic-related exposure to air pollution and noise with the development and progressio...
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abstract:BACKGROUND:Adiponectin is viewed as an insulin-sensitizing hormone with anti-inflammatory effects. In accordance, plasma adiponectin is decreased in metabolic disorders including type 2 diabetes mellitus (T2DM). However, in spite of the apparently beneficially effects, recent data from large prospective studies have co...
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abstract:BACKGROUND:The 6-minute walk test (6 MWT) is widely used to assess exercise tolerance in cardiac rehabilitation (CR). However, previous research shows it to be insufficiently responsive, especially for patients with a relatively high maximal exercise tolerance at baseline. We therefore designed a 6-minute walk/run test...
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doi:10.1177/2047487312437038
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abstract::The clinical benefits of rehabilitation in cardiovascular disease are well established. Among cardiovascular disease patients, however, patients with type 2 diabetes mellitus require a distinct approach. Specific challenges to clinicians and healthcare professionals in patients with type 2 diabetes include the prevale...
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abstract:AIMS:To investigate whether levels of thyroid-stimulating hormone (TSH) within the normal range are associated with an increased risk of new vascular events and mortality in patients with clinical manifest vascular diseases and whether this relation is influenced by adiposity. METHODS AND RESULTS:Prospective cohort st...
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更新日期:2012-08-01 00:00:00
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pub_type: 杂志文章,多中心研究
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abstract:BACKGROUND:The Traveller community are an indigenous minority group in Great Britain and Ireland who experience premature mortality. While minority populations worldwide are known to have high rates of risk factors for cardiovascular disease (CVD), Traveller CVD risk has not previously been defined. DESIGN:All-Ireland...
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abstract:BACKGROUND:Depression is common after a cardiac event; however it often remains untreated. Previously, we reported the efficacy and feasibility of a 6-month tele-health programme (MoodCare), which integrates depression management into a cardiovascular disease (CVD) risk reduction programme for Acute Coronary Syndrome (...
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2015-09-01 00:00:00