HealthDay News — For women, adherence to a Mediterranean diet is associated with a reduced risk for cardiovascular disease (CVD) and mortality, according to a review published online March 14 in Heart.

Anushriya Pant, from the University of Sydney, and colleagues examined the association between higher vs lower adherence to a Mediterranean diet and incident CVD and total mortality among women in a systematic review and meta-analysis. The meta-analysis included 16 prospective cohort studies with 722,495 female participants.

The researchers found that higher adherence to a Mediterranean diet was associated with lower CVD incidence, total mortality, and coronary heart disease (hazard ratios [95% CI], 0.76 [0.72 to 0.81], 0.77 [0.74 to 0.80], and 0.75 [0.65 to 0.87], respectively). Women with higher Mediterranean diet adherence had lower stroke incidence, but the reduction was not statistically significant (hazard ratio, 0.87; 95% CI, 0.76 to 1.01).

“Future research might consider adding more studies that look at the dietary impact on stroke, and subgroup analyses that address female specific cardiovascular risk factors, menopausal status and ethnicity, as well as individual participant data meta-analyses,” the authors write.

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Jamie Kitt, DPhil, from the University of Oxford in the United Kingdom, and colleagues assessed whether remote self-monitoring and physician-guided titration of antihypertensive medications using a Bluetooth-enabled app provides better long-term blood pressure control than usual outpatient care during the first nine months postpartum. The analysis included 200 participants randomly assigned following a hypertensive pregnancy.

The researchers found that the 24-hour mean diastolic blood pressure, measured at 249 days postpartum, was 5.8 mm Hg lower in the intervention group (71.2 vs 76.6 mm Hg) than in the control group (between-group difference, −5.80 mm Hg). Similar results were seen for 24-hour mean systolic blood pressure (114.0 vs 120.3 mm Hg; between-group difference, −6.51 mm Hg).

“An intervention that lowers blood pressure by 5 mm Hg would be expected to delay progression to hypertension by many years and, over a lifetime, reduce risk of cardiovascular or cerebrovascular events,” the authors write.

Two authors disclosed financial ties to Sensyne Health.

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Laura Samples, MD, from the Fred Hutchinson Cancer Center in Seattle, and colleagues examined the optimal treatment of BTKi-associated HTN in a study involving randomly selected patients with lymphoid malignancies on a BTKi and antihypertensive drugs with at least 3 months of follow-up data. Participants were classified as those diagnosed with HTN prior to BTKi initiation (prior HTN; 118 patients) and those diagnosed after BTKi initiation (de novo HTN; 78 patients).

The researchers found that patients with prior HTN who took beta blockers with hydrochlorothiazide and patients diagnosed with de novo HTN who took either an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker with hydrochlorothiazide had significant mean arterial pressure (MAP) reductions (−5.05 and −5.47 mm Hg, respectively). The greatest percentages of normotensive MAPs were also seen in correlation with these regimens.

“Given that increased blood pressure is a ‘class effect’ of treatment with BTKis, both doctors and patients need to be aware of this risk and patients’ blood pressure should be monitored regularly so that treatment can begin immediately when an increase is detected,” Samples said in a statement.

The study was funded by AstraZeneca.

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Chintan V. Dave, PharmD, PhD, from Rutgers University in New Brunswick, New Jersey, and colleagues conducted a retrospective cohort study using target trial emulation for data obtained from 29,648 older longer-term care nursing home residents in the Veterans Health Administration to examine the association between antihypertensive medication initiation and fracture risk.

The researchers found that the incidence rate of fractures per 100 person-years was 5.4 for residents initiating antihypertensive medication vs 2.2 in the control arm in a propensity score-matched cohort of 64,710 residents (mean age, 77.9 years). The finding corresponded to an adjusted hazard ratio of 2.42 and an adjusted excess risk of 3.12 per 100 person-years. There was also an association seen for antihypertensive medication initiation with a higher risk for severe falls requiring hospitalizations or emergency department visits and syncope (hazard ratio, 1.80 and 1.69, respectively). A numerically higher magnitude of fracture risk was observed for subgroups of residents with dementia, systolic blood pressure of 140 mm Hg or higher, diastolic blood pressure of 80 mm Hg or higher, and no recent antihypertensive medication use (hazard ratios, 3.28, 3.12, 4.41, and 4.77, respectively).

“This study sheds light on the potential impact of fracture risk associated with antihypertensive medication use among long-term nursing home residents, emphasizing the need for caution when initiating therapy, especially in the high-risk period after drug initiation,” the authors write.

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(HealthDay News) — For 6 cardiovascular diseases (CVDs) examined, coverage of evidence-based medications varies by low-cost generic program (LCGP), drug, and condition, according to a study published online Sept. 5 in the Annals of Internal Medicine.

Ivy T. Ton, PharmD, from the Western University of Health Sciences in Pomona, California, and colleagues examined LCGPs’ coverage of evidence-based CVD medications in a cross-sectional study of 19 publicly available LCGPs in March and April 2023 in the United States. The proportion of LCGPs that offered evidence-based CVD medicines for 6 CVDs was examined according to 4 metrics (breadth, choice, high-quality evidence, and titratability).

The researchers found variation in the availability of CVD medication by program, drug, and CVD condition. Some of the programs had greater breadth and choice of coverage for most CVDs, while many had more focused coverage, and limited offerings were provided by others.

Angiotensin-converting enzyme inhibitors, β-blockers, thiazides, and moderate-intensity statins were offered by nearly all LCGPs, while lower availability was seen for higher-cost or lower-use generics, including antiplatelets and antiarrhythmics. For atrial fibrillation and heart failure, core pharmacotherapy coverage and choices were limited, while for hypertension and hyperlipidemia, they were widely available.

“Medication coverage in LCGPs varies widely for core, evidence-based CVD medications in all CVD conditions investigated, with differences in medication coverage options and strengths by program and condition,” the authors write. “Health care professionals should consider medication availability and LCGP-specific characteristics when recommending their use.”

One author disclosed ties to the pharmaceutical industry and one to the medical device industry.

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