ESC 2019 — 5 key highlights for primary care

  • Emily Willingham, PhD
  • Conference Reports
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Guidelines, so many guidelines

  • With 5 sets of guidelines emerging from ESC 2019, primary care clinicians may find the pocket versions, available here, to be most accessible. 
  • Guidelines of special interest for primary care include: 
    • Management of chronic coronary syndrome, featuring the first recommendations on limited exposure to air and noise pollution and with a major emphasis on lifestyle modifications.
    • Management of diabetes and prediabetes with cardiovascular disease, also emphasising lifestyle changes for primary prevention and firstline dual therapy for hypertension.
    • Updated cholesterol guidelines that call for a new low for low-density lipoprotein cholesterol targets: 

Immunizing against influenza ... and heart attacks?

  • In patients with hypertension, annual influenza vaccination is linked to an 18% reduced risk for death.
  • The authors of this Danish registry study found reductions in both all-cause and cardiovascular mortality and in acute myocardial infarction and stroke. 

A diabetes drug that reduces heart failure death

  • The audience broke into spontaneous applause when researchers announced that the diabetes drug dapagliflozin was linked to reduced risk for heart failure death or hospitalisation--diabetes or not.

An aspirin a day does not keep disability at bay

  • In healthy older patients, daily low-dose aspirin had no effect on survival or disability-free survival in an Australian trial, but bleeding risk was more than doubled.
  • These authors concluded that aspirin should not be recommended as cardiovascular disease prevention for healthy older people over age 70.

High BMI at a young age poses major risks for the heart

  • A registry study covering almost 1.7 million 18-year-old men in Sweden, followed for up to 46 years, linked higher BMI and the risk for heart attack before age 65.
  • For adolescents in the highest BMI categories, this risk was more than tripled.
  • These authors urge attention to early obesity prevention.