Clinical reviews

Intensive blood pressure (BP) control reduces the risk of developing mild cognitive impairment, but not dementia, a US randomised trial has found.

A novel cuffless device recorded significantly higher values for both systolic and diastolic blood pressure (BP) compared with standard equipment for 24-hour ambulatory BP monitoring, in a small study from Switzerland.

A small but well designed pilot study from Scandinavia has suggested that afternoon exercise improves blood glucose in type 2 diabetes more effectively than exercise in the morning.

An increase in the use of e-cigarettes (vaping) has been associated with a drop in smoking by teenagers and young adults, a time trend analysis from the United States has found.

Living in a smoking household and having peers who smoke are key factors associated with children smoking, a cohort study has found. The investigators analysed data on 11,577 teenagers in the Millenium Cohort Study, a birth cohort of children born between September 2000 and January 2002 in the UK.

Individuals who suffer abuse as children are more likely to use marijuana or cocaine later in life, a study from the United States has found.

There is a strong and independent association between manic episodes and a history of eating nitrate-cured meat products, a US study has found.

The vast majority of children who were obese at three years of age were overweight or obese in adolescence, a study from Germany has found.

Women with a history of pre-eclampsia are three times more likely to develop vascular dementia later on, a Danish cohort study has found.

Atrial fibrillation (AF) patients with a baseline BMI = 30 kg/m² have a higher recurrence rate following catheter ablation, a  study of  an AF Ablation Long-Term Registry that included 104 centres across 27 European countries.

Compared with clopidogrel, prasugrel and, in particular ticagrelor, led to a significant reduction in risk of recurrent fatal and non-fatal myocardial infarction (MI) in patients with acute coronary syndrome (ACS), in a study from France.

Longer duration of breastfeeding appears to reduce the risk of recurrent cough in young adults, a study from the United States has found. The researchers used data from the Tucson Children’s Respiratory Study, a large non-selected birth cohort in which infant feeding practices and adult health outcomes were ascertained prospectively.

The use of sulphonylureas as a second-line substitution for metformin in type 2 diabetes is associated with increased rates of myocardial infarction (MI), all cause death and severe hypoglycaemia, a population-based cohort study has found. The study used data from the UK Clinical Practice Research Datalink (CPRD) to analyse a cohort of type 2 diabetes patients retrospectively. The CPRD contains medical records from more than 14 million patients registered at more than 680 general practices.

Sleeping for more than 8 hours a night was associated with an increased risk of mortality and poor quality sleep with an increased risk of coronary heart disease (CHD), a large meta-analysis has found.

In patients with type 1 diabetes, clinically meaningful and sustained HbA_1c improvement rarely occurs more than five years after diagnosis, a UK study has found.

Current guidelines advise treating paroxysmal AF in the same way as sustained AF but the evidence is weak, with only one retrospective analysis comparing the risk of stroke in patients with paroxysmal AF vs chronic AF (analysis of the SPAF trials, performed 15 years ago and limited to patients treated with aspirin). The ACTIVE W trial showed that warfarin is more effective than aspirin plus clopidogrel for the prevention of vascular events (stroke, embolism, MI and vascular death) in patients with AF. A recent substudy of this trial looked at the risk of stroke in 1,202 patients with paroxysmal AF compared with 5,495 with sustained AF, and the effectiveness of thromboprophylaxis in these patients. ' This substudy has shown that the risk of stroke is similar, irrespective of whether AF is paroxysmal or sustained, and that anticoagulation therapy is equally effective in both groups. Other factors, such as age and cardiovascular comorbidity, remain central to the ultimate choice of thromboprophylaxis in these patients.'