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α2-Adrenergic Agonists or Stimulants for Preschool-Age Children With Attention-Deficit/Hyperactivity Disorder | Attention Deficit/Hyperactivity Disorders | JAMA

α2-Adrenergic Agonists or Stimulants for Preschool-Age Children With Attention-Deficit/Hyperactivity Disorder | Attention Deficit/Hyperactivity Disorders | JAMA
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Big Drops in LDL Cholesterol With Inclisiran, but US Clinicians Still Await Drug's Approval

March 03, 2021
A pooled analysis of clinical trials testing inclisiran (Novartis) that confirms the agent’s potent effects on LDL cholesterol has now been published. Yet the small interfering RNA (siRNA) molecule, which has since been approved in Europe, remains in limbo in the United States.
The analysis, combining patients from three ORION trials, was first presented at the virtual 2020 American College of Cardiology Scientific Session and was published this week in the
Journal of the American College of Cardiology. However, the ultimate green light from the US Food and Drug Administration, which had been hoped for last year, has not yet been given. Last December, the FDA declined to approve inclisiran after identifying problems with a European manufacturing site, a decision that came within weeks of European regulators clearing the siRNA molecule for lowering LDL-cholesterol levels in patients with hypercholesterolemia or mixed dyslipidemia. ....

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NT-proBNP Test Could Help Guide Hypertension Therapy: ARIC Analysis

February 01, 2021
In people with no history of CV disease, N-terminal pro-brain natriuretic peptide (NT-proBNP) levels can predict a higher risk of developing CV disease across various blood pressure and pulse pressure ranges, new data from the Atherosclerosis Risk In Communities (ARIC) study suggest.
The findings raise the possibility of using NT-proBNP tests, which have typically been restricted to the diagnosis and management of heart failure (HF), in the setting of hypertension, researchers say.
Additional information on individual risk could help clinicians refine decisions about therapy, said lead author Aliza Hussain, MD (Baylor College of Medicine, Houston, TX). The most recent hypertension guidelines recommend a treatment goal of less than 130/80 mm Hg across patient groups, she noted, but making a decision to get more aggressive in patients with only moderate hypertension has been a tough sell. ....

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Soft Stuff, Hard Data: AHA Tallies Evidence Linking Psychological Health and CVD

January 27, 2021
Psychological health can affect CVD risk in both negative and positive ways, raising the potential for clinicians to leverage this when caring for patients, asserts a new scientific statement from the American Heart Association (AHA). He compiles the evidence
“The mind, heart, and body are interconnected, and what affects one affects the other two.” said Glenn N. Levine, MD (Baylor College of Medicine, Dallas, TX). “We need to not only treat a specific disease state but [also] at least try as best we can to consider the patient and the person as a whole.”
Levine, who chaired the document’s writing group, said the AHA statement was inspired by his realization about a year and a half ago that there “were more and more high-quality studies that seem to clearly be linking psychological health, both negative and positive, with cardiac risk and cardiac outcomes.” ....

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