Video

SAN FRANCISCO – Obese patients with rheumatoid arthritis are significantly less likely to achieve sustained disease remission than are their peers who are normal weight or overweight, based on data reported at the annual meeting of the American College of Rheumatology.

In an analysis of more than 1,000 patients with RA from the multicenter, prospective CATCH (Canadian Early Arthritis Cohort) study, about 28% of obese (body mass index of 30 kg/m² or greater) patients achieved sustained remission, defined as a 28-joint Disease Activity Score of 2.6 or less at two consecutive clinical visits.

In contrast, 38% of overweight (BMI 25-29.9) and 48% of normal-weight (BMI 18.5-24.9) patients reached that goal, said Dr. Vivian P. Bykerk, director of the Inflammatory Arthritis Center of Excellence at the Hospital for Special Surgery, New York, and a clinical researcher at Weill Cornell Medical College, New York. In an exclusive video interview, Dr. Bykerk discusses the findings and their implications.

Dr. Bykerk is the founder and principal investigator for the CATCH study, which is sponsored by Amgen, Pfizer, Hoffmann-La Roche, UCB Canada, Bristol-Myers Squibb, AbbVie, and Janssen Biotech.

SAN FRANCISCO – Obese patients with rheumatoid arthritis are significantly less likely to achieve sustained disease remission than are their peers who are normal weight or overweight, based on data reported at the annual meeting of the American College of Rheumatology.

In an analysis of more than 1,000 patients with RA from the multicenter, prospective CATCH (Canadian Early Arthritis Cohort) study, about 28% of obese (body mass index of 30 kg/m² or greater) patients achieved sustained remission, defined as a 28-joint Disease Activity Score of 2.6 or less at two consecutive clinical visits.

In contrast, 38% of overweight (BMI 25-29.9) and 48% of normal-weight (BMI 18.5-24.9) patients reached that goal, said Dr. Vivian P. Bykerk, director of the Inflammatory Arthritis Center of Excellence at the Hospital for Special Surgery, New York, and a clinical researcher at Weill Cornell Medical College, New York. In an exclusive video interview, Dr. Bykerk discusses the findings and their implications.

Dr. Bykerk is the founder and principal investigator for the CATCH study, which is sponsored by Amgen, Pfizer, Hoffmann-La Roche, UCB Canada, Bristol-Myers Squibb, AbbVie, and Janssen Biotech.

SAN FRANCISCO – Obese patients with rheumatoid arthritis are significantly less likely to achieve sustained disease remission than are their peers who are normal weight or overweight, based on data reported at the annual meeting of the American College of Rheumatology.

In an analysis of more than 1,000 patients with RA from the multicenter, prospective CATCH (Canadian Early Arthritis Cohort) study, about 28% of obese (body mass index of 30 kg/m² or greater) patients achieved sustained remission, defined as a 28-joint Disease Activity Score of 2.6 or less at two consecutive clinical visits.

In contrast, 38% of overweight (BMI 25-29.9) and 48% of normal-weight (BMI 18.5-24.9) patients reached that goal, said Dr. Vivian P. Bykerk, director of the Inflammatory Arthritis Center of Excellence at the Hospital for Special Surgery, New York, and a clinical researcher at Weill Cornell Medical College, New York. In an exclusive video interview, Dr. Bykerk discusses the findings and their implications.

Dr. Bykerk is the founder and principal investigator for the CATCH study, which is sponsored by Amgen, Pfizer, Hoffmann-La Roche, UCB Canada, Bristol-Myers Squibb, AbbVie, and Janssen Biotech.

ORLANDO – Initiating varenicline while smokers are hospitalized for acute coronary syndrome (ACS) is an effective strategy for boosting 6-month smoking abstinence rates in this extremely high–cardiovascular risk population, Dr. Mark J. Eisenberg said in an interview at the American Heart Association scientific sessions.

At the meeting, Dr. Eisenberg presented the results of the EVITA trial, a multicenter, randomized, double-blind study of 303 U.S. and Canadian patients, all longtime smokers, who began a 12-week course of varenicline (Chantix) at 1 mg twice daily or placebo while hospitalized for ACS. Participants had been smokers for an average of 36 years and smoked 22 cigarettes per day at the time of their ACS.

The 24-week rate of biochemically confirmed abstinence in the placebo group was 32.5%. That’s typical. Numerous studies have shown that less than one-third of smokers remain abstinent once discharged from the hospital following an ACS.

In contrast, the 24-week abstinence rate in the varenicline group was 47.3%. The number needed to treat with varenicline to achieve one additional quitter through 6 months of follow-up was 6.8, according to Dr. Eisenberg, professor of medicine at McGill University and director of the cardiovascular health services research program at Jewish General Hospital, both in Montreal.

Observers hailed this as a practice-changing study, and Dr. Eisenberg concurred. Noting that cardiologists are already comfortable in starting ACS patients on statins, beta-blockers, and aspirin while in hospital, he predicted physicians will seize this unique opportunity to help patients quit smoking as well.

“This is a teachable moment,” Dr. Eisenberg observed. “The public health benefit for smoking cessation in this population is huge. You can cut their risk of death and significant morbidity in half if you can get them to stop smoking.”

[email protected]

ORLANDO – Initiating varenicline while smokers are hospitalized for acute coronary syndrome (ACS) is an effective strategy for boosting 6-month smoking abstinence rates in this extremely high–cardiovascular risk population, Dr. Mark J. Eisenberg said in an interview at the American Heart Association scientific sessions.

At the meeting, Dr. Eisenberg presented the results of the EVITA trial, a multicenter, randomized, double-blind study of 303 U.S. and Canadian patients, all longtime smokers, who began a 12-week course of varenicline (Chantix) at 1 mg twice daily or placebo while hospitalized for ACS. Participants had been smokers for an average of 36 years and smoked 22 cigarettes per day at the time of their ACS.

The 24-week rate of biochemically confirmed abstinence in the placebo group was 32.5%. That’s typical. Numerous studies have shown that less than one-third of smokers remain abstinent once discharged from the hospital following an ACS.

In contrast, the 24-week abstinence rate in the varenicline group was 47.3%. The number needed to treat with varenicline to achieve one additional quitter through 6 months of follow-up was 6.8, according to Dr. Eisenberg, professor of medicine at McGill University and director of the cardiovascular health services research program at Jewish General Hospital, both in Montreal.

Observers hailed this as a practice-changing study, and Dr. Eisenberg concurred. Noting that cardiologists are already comfortable in starting ACS patients on statins, beta-blockers, and aspirin while in hospital, he predicted physicians will seize this unique opportunity to help patients quit smoking as well.

“This is a teachable moment,” Dr. Eisenberg observed. “The public health benefit for smoking cessation in this population is huge. You can cut their risk of death and significant morbidity in half if you can get them to stop smoking.”

[email protected]

ORLANDO – Initiating varenicline while smokers are hospitalized for acute coronary syndrome (ACS) is an effective strategy for boosting 6-month smoking abstinence rates in this extremely high–cardiovascular risk population, Dr. Mark J. Eisenberg said in an interview at the American Heart Association scientific sessions.

At the meeting, Dr. Eisenberg presented the results of the EVITA trial, a multicenter, randomized, double-blind study of 303 U.S. and Canadian patients, all longtime smokers, who began a 12-week course of varenicline (Chantix) at 1 mg twice daily or placebo while hospitalized for ACS. Participants had been smokers for an average of 36 years and smoked 22 cigarettes per day at the time of their ACS.

The 24-week rate of biochemically confirmed abstinence in the placebo group was 32.5%. That’s typical. Numerous studies have shown that less than one-third of smokers remain abstinent once discharged from the hospital following an ACS.

In contrast, the 24-week abstinence rate in the varenicline group was 47.3%. The number needed to treat with varenicline to achieve one additional quitter through 6 months of follow-up was 6.8, according to Dr. Eisenberg, professor of medicine at McGill University and director of the cardiovascular health services research program at Jewish General Hospital, both in Montreal.

Observers hailed this as a practice-changing study, and Dr. Eisenberg concurred. Noting that cardiologists are already comfortable in starting ACS patients on statins, beta-blockers, and aspirin while in hospital, he predicted physicians will seize this unique opportunity to help patients quit smoking as well.

“This is a teachable moment,” Dr. Eisenberg observed. “The public health benefit for smoking cessation in this population is huge. You can cut their risk of death and significant morbidity in half if you can get them to stop smoking.”

[email protected]

ORLANDO – The paradigm-shifting results from the SPRINT trial showed the added benefit from a new target systolic blood-pressure goal of less than 120 mm Hg for many patients with risk factors for cardiovascular disease, but the results did not address the issue of which systolic blood pressure to use to identify patients who have hypertension and require drug intervention.

“We tested a target of less than 120 mm Hg against a target of less than 140 mm Hg; the question of whom to treat and to whom this applies” did not get tested in SPRINT (Systolic Blood Pressure Intervention Trial), Dr. Jackson T. Wright Jr. said in an interview at the American Heart Association scientific sessions.

“What the trial showed was that treating to a systolic blood pressure of less than 120 mm Hg reduced the primary, combined endpoint by [a relative] 25%, reduced all-cause mortality by [a relative] 27%, and reduced heart failure by [a relative] 38%” compared with patients treated to a target systolic pressure of less than 140 mm Hg, said Dr. Wright, professor and director of the clinical hypertension program at University Hospitals Case Medical Center in Cleveland. Concurrently with the study’s report, the SPRINT results appeared in an article published online (N Engl J Med. 2015;doi:10.1056/NEJMoa1511939).

Dr. Wright acknowledged that the more aggressive antihypertensive regimen used in SPRINT to get patients’ systolic blood pressure to a goal of less than 120 mm Hg resulted in an absolute 2.2% increased rate of serious adverse events attributable to study treatment compared with the control patients treated to a target pressure of less than 140 mm Hg, but he contended that the benefits from lower pressure outweighed this risk. Patients in the more aggressive arm required an average of 2.8 drugs/patient compared with an average of 1.8 antihypertensive drugs used by control patients. The average achieved systolic blood pressure in the aggressive arm was 121.5 mm Hg, and 134.6 mm Hg in the control arm.

Patients enrolled in SPRINT had to be at least 50 years old, have a systolic blood pressure of 130-180 mm Hg, and have an increased risk for cardiovascular disease events. That risk was defined as having at least one of these factors: clinical or subclinical cardiovascular disease other than stroke; chronic kidney disease (but excluding polycystic kidney disease) with an estimated glomerular filtration rate of 20-59 mL/min per 1.73 m²; a 10-year cardiovascular disease risk of at least 15% based on the Framingham risk score; or an age of 75 years or older. The study excluded patients with a history of stroke or diabetes.

Subgroup analyses showed consistent benefit across all subgroups including age, gender, race, the presence or absence of chronic kidney disease, and systolic blood pressure at entry. A third of patients entered the trial with a systolic blood pressure of 132 mm Hg or less. Also at baseline, 91% of enrolled patients had already been receiving antihypertensive drugs. Overall, enrolled patients were receiving an average of 1.8 antihypertensive drugs each when they entered the study.

Patients enrolled in SPRINT received treatment for an average of 3.26 years. The investigators had designed SPRINT to run for 5 years but stopped the trial sooner than planned in August when the study’s data and safety monitoring board identified clear evidence of the superiority of the more aggressive treatment that fulfilled the trials prespecified stopping criterion.

SPRINT received no commercial funding. The study received antihypertensive drugs from Arbor and Takeda at no charge for a small percentage of enrolled patients. Dr. Wright had no disclosures.

[email protected]

On Twitter @mitchelzoler

ORLANDO – The paradigm-shifting results from the SPRINT trial showed the added benefit from a new target systolic blood-pressure goal of less than 120 mm Hg for many patients with risk factors for cardiovascular disease, but the results did not address the issue of which systolic blood pressure to use to identify patients who have hypertension and require drug intervention.

“We tested a target of less than 120 mm Hg against a target of less than 140 mm Hg; the question of whom to treat and to whom this applies” did not get tested in SPRINT (Systolic Blood Pressure Intervention Trial), Dr. Jackson T. Wright Jr. said in an interview at the American Heart Association scientific sessions.

“What the trial showed was that treating to a systolic blood pressure of less than 120 mm Hg reduced the primary, combined endpoint by [a relative] 25%, reduced all-cause mortality by [a relative] 27%, and reduced heart failure by [a relative] 38%” compared with patients treated to a target systolic pressure of less than 140 mm Hg, said Dr. Wright, professor and director of the clinical hypertension program at University Hospitals Case Medical Center in Cleveland. Concurrently with the study’s report, the SPRINT results appeared in an article published online (N Engl J Med. 2015;doi:10.1056/NEJMoa1511939).

Dr. Wright acknowledged that the more aggressive antihypertensive regimen used in SPRINT to get patients’ systolic blood pressure to a goal of less than 120 mm Hg resulted in an absolute 2.2% increased rate of serious adverse events attributable to study treatment compared with the control patients treated to a target pressure of less than 140 mm Hg, but he contended that the benefits from lower pressure outweighed this risk. Patients in the more aggressive arm required an average of 2.8 drugs/patient compared with an average of 1.8 antihypertensive drugs used by control patients. The average achieved systolic blood pressure in the aggressive arm was 121.5 mm Hg, and 134.6 mm Hg in the control arm.

Patients enrolled in SPRINT had to be at least 50 years old, have a systolic blood pressure of 130-180 mm Hg, and have an increased risk for cardiovascular disease events. That risk was defined as having at least one of these factors: clinical or subclinical cardiovascular disease other than stroke; chronic kidney disease (but excluding polycystic kidney disease) with an estimated glomerular filtration rate of 20-59 mL/min per 1.73 m²; a 10-year cardiovascular disease risk of at least 15% based on the Framingham risk score; or an age of 75 years or older. The study excluded patients with a history of stroke or diabetes.

Subgroup analyses showed consistent benefit across all subgroups including age, gender, race, the presence or absence of chronic kidney disease, and systolic blood pressure at entry. A third of patients entered the trial with a systolic blood pressure of 132 mm Hg or less. Also at baseline, 91% of enrolled patients had already been receiving antihypertensive drugs. Overall, enrolled patients were receiving an average of 1.8 antihypertensive drugs each when they entered the study.

Patients enrolled in SPRINT received treatment for an average of 3.26 years. The investigators had designed SPRINT to run for 5 years but stopped the trial sooner than planned in August when the study’s data and safety monitoring board identified clear evidence of the superiority of the more aggressive treatment that fulfilled the trials prespecified stopping criterion.

SPRINT received no commercial funding. The study received antihypertensive drugs from Arbor and Takeda at no charge for a small percentage of enrolled patients. Dr. Wright had no disclosures.

[email protected]

On Twitter @mitchelzoler

ORLANDO – The paradigm-shifting results from the SPRINT trial showed the added benefit from a new target systolic blood-pressure goal of less than 120 mm Hg for many patients with risk factors for cardiovascular disease, but the results did not address the issue of which systolic blood pressure to use to identify patients who have hypertension and require drug intervention.

“We tested a target of less than 120 mm Hg against a target of less than 140 mm Hg; the question of whom to treat and to whom this applies” did not get tested in SPRINT (Systolic Blood Pressure Intervention Trial), Dr. Jackson T. Wright Jr. said in an interview at the American Heart Association scientific sessions.

“What the trial showed was that treating to a systolic blood pressure of less than 120 mm Hg reduced the primary, combined endpoint by [a relative] 25%, reduced all-cause mortality by [a relative] 27%, and reduced heart failure by [a relative] 38%” compared with patients treated to a target systolic pressure of less than 140 mm Hg, said Dr. Wright, professor and director of the clinical hypertension program at University Hospitals Case Medical Center in Cleveland. Concurrently with the study’s report, the SPRINT results appeared in an article published online (N Engl J Med. 2015;doi:10.1056/NEJMoa1511939).

Dr. Wright acknowledged that the more aggressive antihypertensive regimen used in SPRINT to get patients’ systolic blood pressure to a goal of less than 120 mm Hg resulted in an absolute 2.2% increased rate of serious adverse events attributable to study treatment compared with the control patients treated to a target pressure of less than 140 mm Hg, but he contended that the benefits from lower pressure outweighed this risk. Patients in the more aggressive arm required an average of 2.8 drugs/patient compared with an average of 1.8 antihypertensive drugs used by control patients. The average achieved systolic blood pressure in the aggressive arm was 121.5 mm Hg, and 134.6 mm Hg in the control arm.

Patients enrolled in SPRINT had to be at least 50 years old, have a systolic blood pressure of 130-180 mm Hg, and have an increased risk for cardiovascular disease events. That risk was defined as having at least one of these factors: clinical or subclinical cardiovascular disease other than stroke; chronic kidney disease (but excluding polycystic kidney disease) with an estimated glomerular filtration rate of 20-59 mL/min per 1.73 m²; a 10-year cardiovascular disease risk of at least 15% based on the Framingham risk score; or an age of 75 years or older. The study excluded patients with a history of stroke or diabetes.

Subgroup analyses showed consistent benefit across all subgroups including age, gender, race, the presence or absence of chronic kidney disease, and systolic blood pressure at entry. A third of patients entered the trial with a systolic blood pressure of 132 mm Hg or less. Also at baseline, 91% of enrolled patients had already been receiving antihypertensive drugs. Overall, enrolled patients were receiving an average of 1.8 antihypertensive drugs each when they entered the study.

Patients enrolled in SPRINT received treatment for an average of 3.26 years. The investigators had designed SPRINT to run for 5 years but stopped the trial sooner than planned in August when the study’s data and safety monitoring board identified clear evidence of the superiority of the more aggressive treatment that fulfilled the trials prespecified stopping criterion.

SPRINT received no commercial funding. The study received antihypertensive drugs from Arbor and Takeda at no charge for a small percentage of enrolled patients. Dr. Wright had no disclosures.

[email protected]

On Twitter @mitchelzoler

San Francisco – Treat-to-target should be the goal of every office visit for rheumatoid arthritis, according to a joint European and North American investigation involving more than 500 patients.

That’s because it works, explained study investigator Dr. Sofia Ramiro, a rheumatology fellow at Leiden (the Netherlands) University Medical Center.

The study confirms what has long been suspected but not exactly demonstrated before in a robust, real-world setting, she noted. The findings also suggest that some rheumatoid arthritis patients probably could be pushed harder toward remission.

In an interview at the annual meeting of the American College of Rheumatology, Dr. Ramiro explained the project and why it matters for clinical care.

[email protected]

San Francisco – Treat-to-target should be the goal of every office visit for rheumatoid arthritis, according to a joint European and North American investigation involving more than 500 patients.

That’s because it works, explained study investigator Dr. Sofia Ramiro, a rheumatology fellow at Leiden (the Netherlands) University Medical Center.

The study confirms what has long been suspected but not exactly demonstrated before in a robust, real-world setting, she noted. The findings also suggest that some rheumatoid arthritis patients probably could be pushed harder toward remission.

In an interview at the annual meeting of the American College of Rheumatology, Dr. Ramiro explained the project and why it matters for clinical care.

[email protected]

San Francisco – Treat-to-target should be the goal of every office visit for rheumatoid arthritis, according to a joint European and North American investigation involving more than 500 patients.

That’s because it works, explained study investigator Dr. Sofia Ramiro, a rheumatology fellow at Leiden (the Netherlands) University Medical Center.

The study confirms what has long been suspected but not exactly demonstrated before in a robust, real-world setting, she noted. The findings also suggest that some rheumatoid arthritis patients probably could be pushed harder toward remission.

In an interview at the annual meeting of the American College of Rheumatology, Dr. Ramiro explained the project and why it matters for clinical care.

[email protected]

ORLANDO – Women’s awareness of the health risk posed by heart disease has stalled, with fully 45% of participants in a nationally representative survey being unaware that heart disease is the number-one killer of U.S. women.

The survey of 1,011 women was commissioned by the Women’s Heart Alliance. The results have provided the group with fresh ideas about how to increase awareness and motivate women to ask their physicians about their heart health, Dr. Holly S. Andersen said in an interview at the American Heart Association scientific sessions.

A key survey finding was that only 27% of women were able to name a woman in their life with heart disease. Even fewer – a mere 11% – could name a woman who has died from it. But the women who had that personal connection to heart disease were 50% more likely to describe themselves as “somewhat or very concerned” about their own risk, and they were also more likely to have asked their physicians about it.

One important strategy going forward will be to focus public education efforts on making heart disease more real and personal for women in an effort to encourage them to learn their personal risk status and take action as warranted, according to Dr. Andersen, scientific adviser to the Women’s Heart Alliance and a cardiologist at New York-Presbyterian Hospital.

[email protected]

ORLANDO – Women’s awareness of the health risk posed by heart disease has stalled, with fully 45% of participants in a nationally representative survey being unaware that heart disease is the number-one killer of U.S. women.

The survey of 1,011 women was commissioned by the Women’s Heart Alliance. The results have provided the group with fresh ideas about how to increase awareness and motivate women to ask their physicians about their heart health, Dr. Holly S. Andersen said in an interview at the American Heart Association scientific sessions.

A key survey finding was that only 27% of women were able to name a woman in their life with heart disease. Even fewer – a mere 11% – could name a woman who has died from it. But the women who had that personal connection to heart disease were 50% more likely to describe themselves as “somewhat or very concerned” about their own risk, and they were also more likely to have asked their physicians about it.

One important strategy going forward will be to focus public education efforts on making heart disease more real and personal for women in an effort to encourage them to learn their personal risk status and take action as warranted, according to Dr. Andersen, scientific adviser to the Women’s Heart Alliance and a cardiologist at New York-Presbyterian Hospital.

[email protected]

ORLANDO – Women’s awareness of the health risk posed by heart disease has stalled, with fully 45% of participants in a nationally representative survey being unaware that heart disease is the number-one killer of U.S. women.

The survey of 1,011 women was commissioned by the Women’s Heart Alliance. The results have provided the group with fresh ideas about how to increase awareness and motivate women to ask their physicians about their heart health, Dr. Holly S. Andersen said in an interview at the American Heart Association scientific sessions.

A key survey finding was that only 27% of women were able to name a woman in their life with heart disease. Even fewer – a mere 11% – could name a woman who has died from it. But the women who had that personal connection to heart disease were 50% more likely to describe themselves as “somewhat or very concerned” about their own risk, and they were also more likely to have asked their physicians about it.

One important strategy going forward will be to focus public education efforts on making heart disease more real and personal for women in an effort to encourage them to learn their personal risk status and take action as warranted, according to Dr. Andersen, scientific adviser to the Women’s Heart Alliance and a cardiologist at New York-Presbyterian Hospital.

[email protected]

SAN FRANCISCO – Deaths from cardiovascular disease are declining in rheumatoid arthritis patients diagnosed after the year 2000, compared with previous decades, according to a new study presented at the annual meeting of the American College of Rheumatology.

The study researchers found significant improvement in the relative 10-year cardiovascular mortality rate, including coronary heart disease mortality, in people with RA in the years 2000-2007, compared with previous decades, explained lead investigator Dr. Elena Myasoedova, assistant professor of medicine at the Mayo Clinic, Rochester, Minn.,

In a video interview, Dr. Myasoedova talked about the trends identified in the study, which included 315 people who developed RA between 2000 and 2007, 498 people who developed RA in earlier years, and 813 people without RA.

Dr. Myasoedova had no relevant financial disclosures.

SAN FRANCISCO – Deaths from cardiovascular disease are declining in rheumatoid arthritis patients diagnosed after the year 2000, compared with previous decades, according to a new study presented at the annual meeting of the American College of Rheumatology.

The study researchers found significant improvement in the relative 10-year cardiovascular mortality rate, including coronary heart disease mortality, in people with RA in the years 2000-2007, compared with previous decades, explained lead investigator Dr. Elena Myasoedova, assistant professor of medicine at the Mayo Clinic, Rochester, Minn.,

In a video interview, Dr. Myasoedova talked about the trends identified in the study, which included 315 people who developed RA between 2000 and 2007, 498 people who developed RA in earlier years, and 813 people without RA.

Dr. Myasoedova had no relevant financial disclosures.

SAN FRANCISCO – Deaths from cardiovascular disease are declining in rheumatoid arthritis patients diagnosed after the year 2000, compared with previous decades, according to a new study presented at the annual meeting of the American College of Rheumatology.

The study researchers found significant improvement in the relative 10-year cardiovascular mortality rate, including coronary heart disease mortality, in people with RA in the years 2000-2007, compared with previous decades, explained lead investigator Dr. Elena Myasoedova, assistant professor of medicine at the Mayo Clinic, Rochester, Minn.,

In a video interview, Dr. Myasoedova talked about the trends identified in the study, which included 315 people who developed RA between 2000 and 2007, 498 people who developed RA in earlier years, and 813 people without RA.

Dr. Myasoedova had no relevant financial disclosures.

SAN FRANCISCO – Mortality rates are declining in people with rheumatoid arthritis (RA) and more closely match those in the general population, according to a retrospective, population-based study reported at the annual meeting of the American College of Rheumatology.

The study did not identify why deaths from cardiovascular disease and cancer declined in people diagnosed with RA in the years 2001-2006, compared with those diagnosed between 1996 and 2000. But the findings suggest that the decline is related to earlier and more aggressive treatment of RA, as well as recognition of the importance of managing cardiovascular risk factors in patients with the disease.

In a video interview, the study’s lead investigator, Dr. Diane Lacaille, professor of rheumatology at the University of British Columbia, Vancouver, discussed the study findings and the implications for management of inflammation in both RA and cardiovascular disease.

Dr. Lacaille had no relevant financial disclosures to report.

SAN FRANCISCO – Mortality rates are declining in people with rheumatoid arthritis (RA) and more closely match those in the general population, according to a retrospective, population-based study reported at the annual meeting of the American College of Rheumatology.

The study did not identify why deaths from cardiovascular disease and cancer declined in people diagnosed with RA in the years 2001-2006, compared with those diagnosed between 1996 and 2000. But the findings suggest that the decline is related to earlier and more aggressive treatment of RA, as well as recognition of the importance of managing cardiovascular risk factors in patients with the disease.

In a video interview, the study’s lead investigator, Dr. Diane Lacaille, professor of rheumatology at the University of British Columbia, Vancouver, discussed the study findings and the implications for management of inflammation in both RA and cardiovascular disease.

Dr. Lacaille had no relevant financial disclosures to report.

SAN FRANCISCO – Mortality rates are declining in people with rheumatoid arthritis (RA) and more closely match those in the general population, according to a retrospective, population-based study reported at the annual meeting of the American College of Rheumatology.

The study did not identify why deaths from cardiovascular disease and cancer declined in people diagnosed with RA in the years 2001-2006, compared with those diagnosed between 1996 and 2000. But the findings suggest that the decline is related to earlier and more aggressive treatment of RA, as well as recognition of the importance of managing cardiovascular risk factors in patients with the disease.

In a video interview, the study’s lead investigator, Dr. Diane Lacaille, professor of rheumatology at the University of British Columbia, Vancouver, discussed the study findings and the implications for management of inflammation in both RA and cardiovascular disease.

Dr. Lacaille had no relevant financial disclosures to report.

NATIONAL HARBOR, MD. – “There may be more to acute heart failure than meets the eye,” Hani N. Sabbah, Ph.D., said in a discussion during the annual meeting of the Heart Failure Society of America.

What remains unclear about acute decompensation episodes in patients with chronic heart failure is whether these events themselves exert a detrimental effect or if decompensation episodes merely flag patients in the worst clinical condition and are part of the natural history of worsening heart failure, said Dr. Sabbah, professor and director of cardiovascular research at Henry Ford Hospital in Detroit.

The importance of acute heart failure decompensations seems comparable to acute MIs, episodes in which incremental declines in heart-muscle function contribute to additional long-term worsening of heart failure, said Dr. Jay N. Cohn, another member of a discussion panel that also included Dr. Sidney Goldstein and Dr. Prakash Deedwania.

The risk from acute decompensations of heart failure highlights the importance of taking steps to cut the incidence of decompensations, said Dr. Cohn. Usual triggers of decompensation that could be targets for prevention are uncontrolled blood pressure and dietary indiscretions, Dr. Deedwania noted. Troponin leaks, a marker of myocardial-cell death, constitute another indicator of acute decompensation that may offer further insight into how to manage these episodes, he said.

Dr. Goldstein had no disclosures. Dr. Deedwania had no disclosures. Dr. Cohn receives royalties from Arbor Pharmaceuticals related to his work on hydralazine and isosorbide dinitrate. Dr. Sabbah is a consultant to Boston Scientific and an advisor to BioControl Medical and he has received research grants from both companies.

[email protected]

On Twitter @mitchelzoler

NATIONAL HARBOR, MD. – “There may be more to acute heart failure than meets the eye,” Hani N. Sabbah, Ph.D., said in a discussion during the annual meeting of the Heart Failure Society of America.

What remains unclear about acute decompensation episodes in patients with chronic heart failure is whether these events themselves exert a detrimental effect or if decompensation episodes merely flag patients in the worst clinical condition and are part of the natural history of worsening heart failure, said Dr. Sabbah, professor and director of cardiovascular research at Henry Ford Hospital in Detroit.

The importance of acute heart failure decompensations seems comparable to acute MIs, episodes in which incremental declines in heart-muscle function contribute to additional long-term worsening of heart failure, said Dr. Jay N. Cohn, another member of a discussion panel that also included Dr. Sidney Goldstein and Dr. Prakash Deedwania.

The risk from acute decompensations of heart failure highlights the importance of taking steps to cut the incidence of decompensations, said Dr. Cohn. Usual triggers of decompensation that could be targets for prevention are uncontrolled blood pressure and dietary indiscretions, Dr. Deedwania noted. Troponin leaks, a marker of myocardial-cell death, constitute another indicator of acute decompensation that may offer further insight into how to manage these episodes, he said.

Dr. Goldstein had no disclosures. Dr. Deedwania had no disclosures. Dr. Cohn receives royalties from Arbor Pharmaceuticals related to his work on hydralazine and isosorbide dinitrate. Dr. Sabbah is a consultant to Boston Scientific and an advisor to BioControl Medical and he has received research grants from both companies.

[email protected]

On Twitter @mitchelzoler

NATIONAL HARBOR, MD. – “There may be more to acute heart failure than meets the eye,” Hani N. Sabbah, Ph.D., said in a discussion during the annual meeting of the Heart Failure Society of America.

What remains unclear about acute decompensation episodes in patients with chronic heart failure is whether these events themselves exert a detrimental effect or if decompensation episodes merely flag patients in the worst clinical condition and are part of the natural history of worsening heart failure, said Dr. Sabbah, professor and director of cardiovascular research at Henry Ford Hospital in Detroit.

The importance of acute heart failure decompensations seems comparable to acute MIs, episodes in which incremental declines in heart-muscle function contribute to additional long-term worsening of heart failure, said Dr. Jay N. Cohn, another member of a discussion panel that also included Dr. Sidney Goldstein and Dr. Prakash Deedwania.

The risk from acute decompensations of heart failure highlights the importance of taking steps to cut the incidence of decompensations, said Dr. Cohn. Usual triggers of decompensation that could be targets for prevention are uncontrolled blood pressure and dietary indiscretions, Dr. Deedwania noted. Troponin leaks, a marker of myocardial-cell death, constitute another indicator of acute decompensation that may offer further insight into how to manage these episodes, he said.

Dr. Goldstein had no disclosures. Dr. Deedwania had no disclosures. Dr. Cohn receives royalties from Arbor Pharmaceuticals related to his work on hydralazine and isosorbide dinitrate. Dr. Sabbah is a consultant to Boston Scientific and an advisor to BioControl Medical and he has received research grants from both companies.

[email protected]

On Twitter @mitchelzoler

NATIONAL HARBOR, MD. – Heart failure with preserved ejection fraction is a disease of premature aging of the myocardium and vasculature that is best managed by prevention, Dr. Jay N. Cohn said in a discussion during the annual meeting of the Heart Failure Society of America.

Heart failure with preserved ejection fraction (HFpEF) was misleadingly paired with heart failure with reduced ejection fraction because both share the symptoms of dyspnea and edema, although they differ in many other ways, added Dr. Cohen, professor of medicine at the University of Minnesota in Minneapolis.

Dr. Cohn said that he has recently prescribed a standard dosage of either an ACE inhibitor or angiotensin receptor–blocker drug to treat patients who have signs of a prematurely aged vasculature. The signs include reduced arterial compliance, thickened carotid walls, endothelial dysfunction, left ventricular hypertrophy, and elevated levels of brain natriuretic peptide. These drug classes offer potential for “vascular healing” at the prevention stage, said Dr. Cohn, who spoke in a group that also included Dr. Sidney Goldstein, Hani N. Sabbah, Ph.D., and Dr. Prakash Deedwania.

The best approach for preventing HFpEF is good management of blood pressure, obesity, and diabetes, said Dr. Sabbah. Good evidence also exists that aldosterone antagonists can reduce fibrosis, part of the pathology behind myocardial and vascular stiffening, he said.

Aldosterone antagonists have been underused for treating HFpEF and should be used more often, Dr. Cohn said.

Dr. Goldstein had no disclosures. Dr. Deedwania had no disclosures. Dr. Cohn receives royalties from Arbor Pharmaceuticals related to his work on hydralazine and isosorbide dinitrate. Dr. Sabbah is a consultant to Boston Scientific and an advisor to BioControl Medical and has received research grants from both companies.

[email protected]

On Twitter @mitchelzoler

NATIONAL HARBOR, MD. – Heart failure with preserved ejection fraction is a disease of premature aging of the myocardium and vasculature that is best managed by prevention, Dr. Jay N. Cohn said in a discussion during the annual meeting of the Heart Failure Society of America.

Heart failure with preserved ejection fraction (HFpEF) was misleadingly paired with heart failure with reduced ejection fraction because both share the symptoms of dyspnea and edema, although they differ in many other ways, added Dr. Cohen, professor of medicine at the University of Minnesota in Minneapolis.

Dr. Cohn said that he has recently prescribed a standard dosage of either an ACE inhibitor or angiotensin receptor–blocker drug to treat patients who have signs of a prematurely aged vasculature. The signs include reduced arterial compliance, thickened carotid walls, endothelial dysfunction, left ventricular hypertrophy, and elevated levels of brain natriuretic peptide. These drug classes offer potential for “vascular healing” at the prevention stage, said Dr. Cohn, who spoke in a group that also included Dr. Sidney Goldstein, Hani N. Sabbah, Ph.D., and Dr. Prakash Deedwania.

The best approach for preventing HFpEF is good management of blood pressure, obesity, and diabetes, said Dr. Sabbah. Good evidence also exists that aldosterone antagonists can reduce fibrosis, part of the pathology behind myocardial and vascular stiffening, he said.

Aldosterone antagonists have been underused for treating HFpEF and should be used more often, Dr. Cohn said.

Dr. Goldstein had no disclosures. Dr. Deedwania had no disclosures. Dr. Cohn receives royalties from Arbor Pharmaceuticals related to his work on hydralazine and isosorbide dinitrate. Dr. Sabbah is a consultant to Boston Scientific and an advisor to BioControl Medical and has received research grants from both companies.

[email protected]

On Twitter @mitchelzoler

NATIONAL HARBOR, MD. – Heart failure with preserved ejection fraction is a disease of premature aging of the myocardium and vasculature that is best managed by prevention, Dr. Jay N. Cohn said in a discussion during the annual meeting of the Heart Failure Society of America.

Heart failure with preserved ejection fraction (HFpEF) was misleadingly paired with heart failure with reduced ejection fraction because both share the symptoms of dyspnea and edema, although they differ in many other ways, added Dr. Cohen, professor of medicine at the University of Minnesota in Minneapolis.

Dr. Cohn said that he has recently prescribed a standard dosage of either an ACE inhibitor or angiotensin receptor–blocker drug to treat patients who have signs of a prematurely aged vasculature. The signs include reduced arterial compliance, thickened carotid walls, endothelial dysfunction, left ventricular hypertrophy, and elevated levels of brain natriuretic peptide. These drug classes offer potential for “vascular healing” at the prevention stage, said Dr. Cohn, who spoke in a group that also included Dr. Sidney Goldstein, Hani N. Sabbah, Ph.D., and Dr. Prakash Deedwania.

The best approach for preventing HFpEF is good management of blood pressure, obesity, and diabetes, said Dr. Sabbah. Good evidence also exists that aldosterone antagonists can reduce fibrosis, part of the pathology behind myocardial and vascular stiffening, he said.

Aldosterone antagonists have been underused for treating HFpEF and should be used more often, Dr. Cohn said.

Dr. Goldstein had no disclosures. Dr. Deedwania had no disclosures. Dr. Cohn receives royalties from Arbor Pharmaceuticals related to his work on hydralazine and isosorbide dinitrate. Dr. Sabbah is a consultant to Boston Scientific and an advisor to BioControl Medical and has received research grants from both companies.

[email protected]

On Twitter @mitchelzoler