A Scottish patient has become the first person in the world to receive a pioneering therapy aimed at improving outcomes for those having heart bypass surgery. The treatment involves precisely editing DNA in veins to be used during heart bypass surgery to boost the production of a protective protein.
The treatment could help extend the lifespan of blood vessels used during the surgery and significantly improve patient health, experts say.
Cause of failures in bypass surgery
Heart bypass surgery – an operation to improve blood flow to the heart – is a life-saving treatment for patients with coronary heart disease.
The process typically uses one artery and two or more veins as bypass grafts – healthy blood vessels used to bypass a narrowed or blocked artery – creating a new route for blood to flow.
Vein grafts used in this type of surgery can fail because they are not naturally designed to withstand the high pressure of blood flow from the heart.
Protecting vein grafts
The PROTECT study, led by NHS Greater Glasgow and Clyde and the University of Glasgow in collaboration with NHS Golden Jubilee and the University of Edinburgh, is trialling a new gene therapy designed to support newly grafted blood vessels.
The treatment will introduce a gene, which produces a protein called TIMP-3, into the vein to be grafted.
TIMP-3 is involved in tissue remodelling. Higher levels of the protein could help to prevent thickening and blockage of the blood vessel over time, scientists say.
Exciting milestone
The research team has developed a way to treat the graft directly at the time of surgery, safely and efficiently delivering the gene therapy to the affected tissue before grafting into the heart.
It is hoped the treatment will help to extend a patient’s healthy life expectancy and reduce the need for further surgeries, experts say.
Many people stop taking cholesterol-lowering statins because they experience muscle aches, weakness, and fatigue. A new study by Columbia researchers now suggests that at least for some people, the side effects arise when statins bind to a protein in muscle cells and cause a leak of calcium ions inside the cells.
“It is unlikely that this explanation applies to everyone who experiences muscular side effects with statins, but even if it explains a small subset, that’s a lot of people we could help if we can resolve the issue,” says Andrew Marks, chair of the Department of Physiology and Cellular Biophysics at the Vagelos College of Physicians and Surgeons.
About 10% of adults taking statins experience these muscular side effects.
“I’ve had patients who’ve been prescribed statins, and they refused to take them because of the side effects. It’s the most common reason patients quit statins, and it’s a very real problem that needs a solution,” says Marks.
Electron microscopy pinpoints statin-muscle interaction
Statins’ muscular side effects have puzzled researchers since the drugs hit the market in the late 80s. Statins are designed to lower cholesterol by binding to an enzyme involved in cholesterol synthesis. But statins also bind to other “off-target” molecules, and some previous studies have suggested that muscular side effects occur when statins bind to a specific protein in muscle.
With cryo-electron microscopy, a technique that can image molecules down to individual atoms, the researchers of the new study documented this binding and uncovered the precise details of the interaction.
Simvastatin molecules bind to two locations on a muscle protein, called the ryanodine receptor, which opens a channel in the receptor. The flow of calcium through the open channel could explain the muscular side effects of statins.
The images revealed two locations on the muscle protein, called the ryanodine receptor, where a statin called simvastatin binds, opening a channel in the receptor and allowing calcium to flow through.
The calcium leak could explain the muscular side effects of statins, Marks says, by weakening the muscle directly or by activating enzymes that degrade muscle tissue.
Building a better statin
The new images also suggest that statins could be redesigned so they do not bind the ryanodine receptor but retain their cholesterol-lowering ability.
Marks is now collaborating with chemists to create such a statin.
Plugging the calcium leak could be another option: Statin-induced calcium leaks in mice can be closed, the researchers showed, with an experimental drug developed in the Marks lab for other conditions involving calcium leaks.
These drugs are currently being tested in people with rare muscle diseases. If it shows efficacy in those patients, we can test it in statin-induced myopathies,” Marks says
A new ACC Scientific Statement on Inflammation and Cardiovascular Disease (CVD) highlights new groundbreaking research linking inflammation atherosclerotic cardiovascular disease (ASCVD) and provides consensus-based recommendations for evaluation, treatment and prevention reflecting this new era.
“The evidence linking inflammation with ASCVD is no longer exploratory but is compelling and clinically actionable,” write the authors, led by Writing Committee Chair George A. Mensah, MD, FACC. “The time for taking action has now arrived.”
Published in JACC, the Statement includes specific recommendations for screening, evaluation, and CVD risk assessment; inflammatory biomarkers in cardiovascular imaging; inflammation inhibition in behavioural and lifestyle risks; and anti-inflammatory approaches in primary and secondary prevention, as well as in heart failure and other cardiovascular diseases.
Among the key takeaways:
High-sensitivity C-reactive protein (hsCRP) is an inexpensive and widely available blood test. While there has been debate within the medical community regarding the utility of hsCRP, this statement details the data confirming its value in clinical decision making in primary and secondary prevention.
In patients with known CVD, hsCRP level is at least as predictive of future events as LDL cholesterol levels, even in patients treated with statin therapy.
The important role of lifestyle interventions to reduce systemic inflammation is emphasised, including regular exercise (at least 150 minutes/week), Mediterranean or DASH Diet, and intake of omega-3 fatty acids, including two to three meals per week of fatty fish high in EPA and DHA. This advice aligns with lifestyle management recommendations in the 2025 ACC/AHA High Blood Pressure Guideline
The Statement also discusses current challenges and opportunities based on the new evidence, exploring topics like the advancing field of cardioimmunology and areas for further research, such as the interplay between inflammation and key physiological systems, the role of novel special pro-resolving bioactive lipid molecules in promoting the resolution of inflammation and CVD risk reduction, and more.
The authors close with a call for action to “embrace anti-inflammatory interventions in patients with established ASCVD” and for clinical practice guidelines that implement “broad screening of primary and secondary prevention patients for hsCRP, in combination with LDL cholesterol.” Additionally, they note: “The time is also ripe for the development of strategies to promote increased physician awareness of the crucial role of inflammation in CVD and accelerate the adoption of evidence-based, guideline-directed anti-inflammatory therapy through dissemination and implementation research.”
Planned birth at term reduces the incidence of pre-eclampsia in women at high risk of the condition, without increasing emergency Caesarean or neonatal unit admission, according to new trial results.
The PREVENT-PE trial, led by researchers from King’s College London and King’s College Hospital NHS Foundation Trust, is the first to find that a strategy of screening for pre-eclampsia risk at 36 weeks of pregnancy, and then offering planned early term delivery according to the mother’s risk, can reduce the incidence of subsequent pre-eclampsia by 30%, compared with usual care.
The trial, funded by the Fetal Medicine Foundation (FMF), also found that the intervention did not increase the rates of birth by emergency Caesarean or neonatal care needs, and there was no evidence of other harms to mother or baby.
Pre-eclampsia is high blood pressure that develops during pregnancy, most commonly at term gestational age. Pre-eclampsia affects 2-8% of pregnancies worldwide and can be life-threatening – there are around 46,000 maternal deaths due to pre-eclampsia each year and around 500,000 foetal or newborn deaths.1
Pre-eclampsia usually develops after 20 weeks of pregnancy, or soon after the baby is born. While aspirin can be taken to significantly reduce the risk of developing pre-eclampsia before 37 weeks of pregnancy, there are no treatments available to reduce risk at term (37-42 weeks).
Building on findings from an earlier data analysis, the PREVENT-PE trial recruited over 8,000 women from King’s College Hospital and Medway NHS Foundation Trusts. Women were randomly allocated into one of two groups: the intervention group (risk assessment for pre-eclampsia, followed by planned early term delivery according to risk) and the control group (usual care at term).
Pre-eclampsia risk was assessed using a model developed by the FMF, which combines maternal demographics and history, with blood pressure, and specific markers in the blood.
Those at high risk of developing pre-eclampsia at term were offered planned birth at 37, 38, 39 or 40 weeks of pregnancy. Women considered to be at low risk received usual care, according to their hospital protocols and UK standards of care.
A 30% reduction in term pre-eclampsia, from 5.6% to 3.9%, is very important. It represents an even greater reduction in the number of pre-eclampsia cases than we can achieve for preterm pre-eclampsia with aspirin.Professor Kypros Nicolaides, founder and chairman of the Fetal Medicine Foundation, and senior author of the paper
This trial took place in busy NHS maternity units serving a highly diverse population, and often socially deprived communities where the burden of pre-eclampsia is greatest. The high level of participation and adherence shows that a personalised, risk-based approach is acceptable, practical, and aligns with what women want from their care. Achieving a 30% reduction in term pre-eclampsia, without increasing emergency Caesarean birth or neonatal admissions, represents a meaningful and reassuring improvement for women, babies, and maternity services.Dr Argyro Syngelaki, Reader in Maternal-Fetal Medicine at King’s College London and co-lead author of the paper
We will soon report on the health economic implications of the trial, as well as the experiences of women and staff who participated, to provide policy-makers with the information that they need to implement the trial intervention within the NHS.Professor Laura A. Magee, Professor of Women’s Health at King’s College London and co-author of the paper
Caffeine may have been unfairly portrayed as the villain in some heart rhythm disorders, according to a new study published in the Journal of the American Medical Association.
Longstanding medical advice has held that patients with atrial fibrillation (AF) should cut back on their caffeine intake – or eliminate it entirely – to improve their condition. Wong et al. conducted an investigation into the relationship between regular caffeinated coffee consumption and the recurrence of atrial fibrillation (AF) or atrial flutter.
The DECAF randomised clinical trial, conducted across five international centres, enrolled 200 patients with persistent AF who were successfully cardioverted and then randomised to either consume caffeinated coffee (averaging one cup daily) or abstain from coffee and caffeine for six months. But contrary to expectations, the caffeine group actually saw an improvement in symptoms.
A speedy new scan could improve how millions of people with hypertension are treated, suggests a new study
Credit: Pixabay CC0
About a quarter of people with high blood pressure have been estimated to have primary aldosteronism, a problem with their adrenal glands producing too much of the hormone aldosterone, which regulates levels of salt in the body.
This problem is often missed, as the path to diagnosis is complex, involving multiple tests and, to guide treatment, an invasive procedure that is not always reliable.
The new 10-minute scan, developed at University College London and described in a research letter in the New England Journal of Medicine (NEJM), reveals overactivity in adrenal glands that was invisible with conventional tests, showing exactly where too much aldosterone is being made.
This, the researchers say, will make it easier to decide on the best treatment approach – either removal of an adrenal gland that is producing too much aldosterone, or the use of new medications that block aldosterone production, targeting the cause of high blood pressure in many patients.
Professor Bryan Williams, Chair of Medicine at UCL and clinical lead for the study, said: “We have been waiting for a test like this for many decades. This British innovation is going to transform the diagnosis of aldosterone excess as an important and previously hidden cause of hypertension in many of our patients. It offers huge potential to completely change the way we make this diagnosis and enable us to provide better targeted treatment for our patients.”
The over-production of aldosterone, which raises high blood pressure by causing the body to retain too much salt, can result in a condition called primary aldosteronism, which increases the risk of heart disease, stroke and kidney disease. However, many people who do not meet the threshold for this condition are thought to have excess aldosterone raising their blood pressure.
Currently the condition is screened with a blood test and confirmed with a second test*. To decide on treatment, two catheters are inserted in veins on either side of the groin to measure levels of aldosterone on each side of the body. This helps clinicians determine if the problem is only located in one adrenal gland or both – but the test is not always accurate and not often offered as few hospitals have the expertise to perform this complex procedure.
To better detect the condition, researchers at UCL used a PET-CT scan, which creates detailed 3D images of parts of the inside of the body and maps the accumulation of a tiny amount of radioactive tracer injected into a person’s vein.
They built a new tracer compound designed to bind to the aldosterone-producing enzyme, aldosterone synthase. The tracer was highly selectively taken up by the parts of the adrenal gland that were over-producing aldosterone, lighting up these areas on the scan.
In their NEJM research letter, the researchers described how 17 patients were scanned in the world’s first use of this technique at UCLH. The team found the source of over-production of aldosterone in every patient and did not see any side effects.
Professor Williams added: “This is the first time we have been able to visualise this disease. We can see it light up on the scan. The intensity of the signal reflects the level of aldosterone over-production. This might allow us, in future, to more precisely target these over-producing areas.”
The achievement builds on more than a decade’s work by Professor Erik Arstad (UCL Division of Medicine and UCL Chemistry) and colleagues, who pioneered and patented a new method to make radioactive tracers.
Using this method, they were able to repurpose a drug-like molecule that bound to the aldosterone-producing enzyme for use as a tracer, replacing a single atom with a radioactive version of that atom – meaning this molecule would light up on a PET-CT scan.
Professor Arstad said: “It is very rewarding to be able to bring laboratory innovation into the clinic for the benefit of patients with hard-to-treat hypertension.”
The study was conducted at UCL and UCLH and was funded by the MRC and the NIHR University College London Hospitals Biomedical Research Centre.
The team is now embarking on a phase 2 clinical trial to gather sufficient data for the test to be approved for routine clinical use in the NHS.
In the UK, more than 14 million people are estimated to have high blood pressure (about one in three adults).
*For instance, a salt loading test, where a person increases their intake of salt (sodium), which would be expected to suppress aldosterone levels. If aldosterone levels are still high despite this increase, that confirms a primary hyperaldosteronism diagnosis.
Right side heart failure. Credit: Scientific Animations CC4.0
A simple neck scan can identify men with double the risk of heart failure, according to a new study led by UCL researchers and funded by the British Heart Foundation and the National Institute for Health and Care Research.
A carotid ultrasound, like the ultrasound for pregnant women, is quick and painless, using a small handheld device moved gently over the neck to scan the arteries underneath.
When around 1600 men over the age of 70 received the scan, it showed the ‘flexibility’ of their carotid arteries – how much they stretch and expand with each heartbeat.
Researchers found that the quarter of men with the least flexible carotid arteries were 2.5 times more likely to develop heart failure than those with the most flexible carotid arteries.
These people could be encouraged by doctors to eat more healthily, do more exercise and take medications, if needed, to help reduce their risk of developing heart failure.
GPs do not currently routinely carry out the cheap and easy scan on healthy patients without symptoms. But, where GP surgeries have the capacity, offering a neck scan to older people to measure the flexibility of their arteries could help them better understand their risk of future heart failure, according to the researchers.
Having relied upon data from the British Regional Heart Study, which began in the 1970s and only involved men, researchers highlight that these findings next need to be looked at in women.
Dr Atinuke Akinmolayan (UCL Primary Care & Population Health), who is now a GP, said: “The carotid ultrasound is a safe, cheap and painless investigation, and our findings suggest it may be able to provide an early warning sign for heart failure.
“More research is needed, especially to see if this works for women, but this is something GPs could look at offering to people over the age of 60, where possible and believed needed.
“A patient who gets an ultrasound result indicating they may be at higher risk of future heart failure could have an important conversation with their doctor about lifestyle changes they could make to lower that risk.”
Doctors tend to scan the two carotid arteries, which run up either side of the neck, when someone has had a stroke or is at risk of a stroke following a transient ischaemic attack, known as a ‘mini-stroke’. A scan can identify carotid artery disease – a build-up of fatty material which can cause a stroke by breaking off and travelling into the brain or by narrowing the arteries and stopping blood reaching the brain.
However, the carotid arteries may be a red flag for heart failure also. This is because, when the carotid arteries become less flexible, they do not expand properly to let blood through. This can raise blood pressure, which forces the heart muscle to work harder. Over time, this can lead to heart failure.
The study, published in the Journal of the American Heart Association, looked at 1631 British men, aged 71 to 92, who had a carotid artery ultrasound between 2010 and 2012 as part of the British Regional Heart Study.
A carotid ultrasound, sometimes called a Doppler scan, takes an average of 15 to 30 minutes for most people, although this can vary.
A small handheld sensor is moved back and forth over the neck, generating sound waves which bounce off the arteries. That provides an echo which changes in frequency when blood flow is reduced in the blood vessels because they are narrowed by built-up fatty material.
The narrowing identified by a carotid scan can then be used to calculate the arteries’ flexibility, after factoring in other measures, including blood pressure. Researchers were able to identify the quarter of men with the least flexible carotid arteries, and the quarter of men whose carotid arteries were most flexible.
They then compared the rates of heart failure in each group over an average of six years after their neck scans.
Even after considering other causes of heart failure, like age, weight, smoking and whether people had previously suffered a heart attack, the quarter of men with the least flexible carotid arteries had 2.5 times the risk of developing heart failure, compared to the quarter with the most flexible carotid arteries.
In a separate finding, looking at the thickness of people’s carotid arteries rather than their flexibility, the study found that men with thicker carotid arteries were more likely to have a heart attack or die from one.
For every ‘unit’ increase in the thickness of the carotid artery wall – with a unit equalling 0.16 millimetres – the risk of having a heart attack increased by about 29 per cent, even after considering other relevant factors like age and weight.
However the thickness of the carotid arteries was not found to be significantly linked to future heart failure in the study.
There are around 200 000 new cases of heart failure diagnosed every year in the UK.
It occurs when the heart is not pumping blood around the body as well as it should, most commonly when the heart muscle has been damaged – for example, after a heart attack.
Heart failure can cause extreme fatigue, shortness of breath and fainting.
Professor Bryan Williams, chief scientific and medical officer at the British Heart Foundation (BHF), who is also Chair of Medicine at UCL Institute of Cardiovascular Science, said: “The findings of this study are interesting and show that stiffening of arteries is associated with increased risk of heart failure, most likely due to the heart having to work harder against the resistance caused by these stiffer arteries.
“It is an important signal that whenever we detect such changes in the carotid arteries, we should also be thinking of the potential impact on the heart and an increased risk of heart failure – which we have treatment strategies to prevent.”
People who regularly consume polyphenol-rich foods and drinks, such as tea, coffee, berries, cocoa, nuts, whole grains and olive oil, may have better long-term heart health.
The research, led by King’s College London, found that those with higher adherence to polyphenol-rich dietary patterns had lower predicted cardiovascular disease (CVD) risk.
Polyphenols are natural compounds found in plants that are linked to various health benefits, including improved heart, brain, and gut health.
The study, published in BMC Medicine, followed more than 3100 adults from the TwinsUK cohort for over a decade, found that diets rich in specific groups of polyphenols were linked to healthier blood pressure and cholesterol profiles, contributing to lower CVD risk scores.
For the first time, the researchers also analysed a large number of metabolites in the urine that are produced when the body breaks down polyphenols.
These biomarkers confirmed that individuals with higher levels of polyphenol metabolites—especially those derived from specific groups of polyphenols, flavonoids and phenolic acids – had lower cardiovascular risk scores. They also had increased HDL cholesterol, also know as ‘good’ cholesterol.
The study used a newly developed polyphenol dietary score (PPS) to capture intake of 20 key polyphenol-rich foods commonly consumed in the UK, ranging from tea and coffee to berries, olive oil, nuts, and whole grains.
This score showed stronger associations with cardiovascular health than estimates of total polyphenol intake, likely because it captures overall dietary patterns rather than individual compounds.
This finding suggests that considering the whole diet provides a more accurate picture of how polyphenol-rich foods work together to support long-term heart health.
Our findings show that long-term adherence to polyphenol-rich diets can substantially slow the rise in cardiovascular risk as people age. Even small, sustained shifts towards foods like berries, tea, coffee, nuts, and whole grains may help protect the heart over time.”
Professor Ana Rodriguez-Mateos, Professor of Human Nutrition at King’s College London
Dr Yong Li, first author of the study, added: “This research provides strong evidence that regularly including polyphenol-rich foods in your diet is a simple and effective way to support heart health. These plant compounds are widely available in everyday foods, making this a practical strategy for most people.”
The researchers note that while cardiovascular risk naturally increases with age, higher polyphenol intake was associated with a slower progression of risk over the 11-year follow-up period. They also emphasise the need for future dietary intervention studies to further validate these associations.
Depression resulting from pain may be a contributing factor in the development of high blood pressure, finds a new study
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Chronic pain in adults may increase their risk of high blood pressure, and the location and extent of pain and if they also had depression were contributing factors, according to new research published in Hypertension, an American Heart Association journal.
An analysis of health data for more than 200 000 adults in the US found that those who reported chronic pain throughout their bodies were more likely to develop high blood pressure than people who reported no pain, short-term pain or pain limited to specific areas.
“The more widespread their pain, the higher their risk of developing high blood pressure,” said lead study author Jill Pell, MD, CBE, Professor of Public Health at the University of Glasgow. “Part of the explanation for this finding was that having chronic pain made people more likely to have depression, and then having depression made people more likely to develop high blood pressure. This suggests that early detection and treatment of depression, among people with pain, may help to reduce their risk of developing high blood pressure.”
High blood pressure and hypertension occurs when the force of blood pushing against the walls of blood vessels is too high, and it increases the risk of heart attack or stroke. High blood pressure as well as stage one or stage two hypertension, which includes blood pressure measures from 130/80mmHg to 140/90mmHg or higher, affects nearly half of all adults in the US, and is the leading cause of death in the US and around the world, according to the 2025 joint American Heart Association/American College of Cardiology guideline endorsed by 11 other organisations.
According to previous research, chronic musculoskeletal pain – pain in the hip, knee, back or neck/shoulder that lasts for at least three months – is the most common type of pain in the general population. This study investigated the associations between the type, location and extent of pain throughout the body and the development of high blood pressure.
Inflammation and depression are both known to raise the risk of high blood pressure; however, no prior studies have examined the extent to which the link between pain and high blood pressure is mediated through inflammation and depression, Pell said.
In this study, participants completed a baseline questionnaire and provided information about whether they had experienced pain in the last month that interfered with their usual activities. They noted if the pain was in their head, face, neck/shoulder, back, stomach/abdomen, hip, knee or all over their body. If they reported pain, they indicated whether pain had persisted for more than three months.
Depression was gauged based on participants’ responses to a questionnaire that asked about the frequency of depressed mood, disinterest, restlessness or lethargy in the previous two weeks. Inflammation was measured with blood tests for C-reactive protein (CRP).
After an average follow-up of 13.5 years, the analysis found:
Nearly 10% of all participants developed high blood pressure.
Compared to people who did not have pain, people with chronic widespread pain had the highest risk of high blood pressure (75% increased risk), while short-term pain was associated with a 10% higher risk and chronic localized pain was linked with a 20% higher risk.
When comparing sites of pain to people without pain, the analysis showed that chronic, widespread pain was associated with a 74% higher risk of developing high blood pressure; chronic abdominal pain with a 43% higher risk; chronic headaches with a 22% higher risk; chronic neck/shoulder pain with a 19% higher risk; chronic hip pain with a 17% higher risk; and chronic back pain with a 16% higher risk.
Depression (11.3% of participants) and inflammation (0.4% of participants) accounted for 11.7% of the association between chronic pain and high blood pressure.
“When providing care for people with pain, health care workers need to be aware that they are at higher risk of developing high blood pressure, either directly or via depression. Recognising pain could help detect and treat these additional conditions early,” Pell said.
Daniel W. Jones, MD, FAHA, chair of the 2025 American Heart Association/American College of Cardiology High Blood Pressure Guideline and dean and professor emeritus of the University of Mississippi School of Medicine in Jackson, Mississippi, said, “It is well known that experiencing pain can raise blood pressure in the short term, however, we have known less about how chronic pain affects blood pressure. This study adds to that understanding, finding a correlation between the number of chronic pain sites and that the association may be mediated by inflammation and depression.”
Jones, who was not involved in this research, suggests further exploration of the relationship through randomized controlled trials of approaches to pain management and blood pressure, especially the use of Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) such as ibuprofen, which may also cause an increase in blood pressure.
“Chronic pain needs to be managed within the context of the patients’ blood pressure, especially in consideration of the use of pain medication that may adversely affect blood pressure,” said Jones.
The study’s limitations include that participants were middle- and older-aged adults who were mainly white people of British origin; therefore, the study’s findings may not be generalizable to people from other racial or ethnic groups, living in other countries or adults in other age groups. In addition, the information about levels of pain was self-reported, and the study relied on clinical diagnostic coding, a one-time pain assessment and two blood pressure measurements.
Study details, background and design:
The study reviewed data from the UK Biobank, a large population-based study that recruited more than 500 000 adults who were ages 40-69 when they joined the study between 2006 and 2010. Participants lived in England, Scotland and Wales.
This analysis included 206,963 adults. The average age of the participants was 54 years; 61.7% were women, and 96.7% were white adults.
Among all participants, 35.2% reported experiencing chronic musculoskeletal pain; 62.2% reported chronic pain at one site of the body; 34.9% reported chronic pain at two to three musculoskeletal sites; and 3.2% reported pain at four sites.
When compared with participants who reported no pain, participants reporting pain were more likely to be women, have an unhealthy lifestyle, larger waist circumference, higher body mass index (BMI), more long-term health conditions and live in areas with higher unemployment, lower home and car ownership and more overcrowding.
The researchers adjusted for factors associated with both pain and high blood pressure, including self-reported smoking status, alcohol consumption, physical activity, total sedentary time, sleep duration, and fruit and vegetable intake.
UK Biobank data was collected at the participants’ baseline appointment through a touch-screen questionnaire, interview, physical measurements (height, weight, BMI, waist circumference, blood pressure measurement) and blood samples taken for cholesterol and blood sugar (hemoglobin A1c).
The participants’ hospital records identified incidences of high blood pressure, which were defined using the standard International Statistical Classification of Diseases and Related Problems and diagnostic codes (ICD-10 codes).
The study’s follow-up duration was determined by measuring the time from the baseline date until one of the following events occurred: a recorded diagnosis of high blood pressure, the participant’s death or censoring due to reaching the end of follow-up records. The earliest of these events marked the end of the follow-up period for each participant.
Co-authors, disclosures and funding sources are listed in the manuscript.
Researchers found that low-dose colchicine can be used to reduce heart attacks and strokes in high-risk patients
Photo by Towfiqu Barbhuiya on Unsplash
A widely-used, inexpensive gout drug could reduce heart attacks and strokes in people with cardiovascular disease, according to a new Cochrane review.
The review examined the effects of low doses of colchicine, a drug used to treat gout, and found no increase in serious side effects.
Cardiovascular disease is often driven by chronic low-grade inflammation, which contributes to recurrent cardiovascular events such as heart attacks and strokes. Colchicine has anti-inflammatory properties that make it a promising option for people with heart disease.
A promising effect on cardiovascular risk
The review included 12 randomised controlled trials involving nearly 23 000 people with a history of heart disease, heart attack or stroke. The studies looked at patients who took colchicine for at least six months, with doses of 0.5mg once or twice a day. Most participants were male (~80%) and the mean age was 57 to 74 years old. Half received colchicine, while the other half received either a placebo or no additional treatment alongside their usual care.
Overall, those taking low-dose colchicine were less likely to experience a heart attack or stroke. For every 1000 people treated, there were 9 fewer heart attacks and 8 fewer strokes compared with those not taking the drug. Whilst there were no serious adverse events identified, patients who took colchicine were more likely to have stomach or digestive side effects, but these were usually mild and didn’t last long.
Among 200 people with cardiovascular disease – where we would normally expect around seven heart attacks and four strokes – using low-dose colchicine could prevent about two of each. Reductions like this can make a real difference for patients who live with ongoing, lifelong cardiovascular risk.
– Dr Ramin Ebrahimi, co-lead author from the University Medicine Greifswald, Germany
A new use for a long-established medicine
As cardiovascular diseases are the leading cause of death globally, colchicine presents a promising inexpensive and accessible option for secondary prevention in high-risk patients.
These results come from publicly funded trials repurposing a very old, low-cost drug for an entirely new use. It shows the power of academic research to reveal treatment opportunities that traditional drug development often overlooks.
– Lars Hemkens, senior author from the University of Bern, Switzerland
The evidence is less clear when it comes to whether colchicine affects overall death rates or the need for procedures like coronary revascularisation. The studies didn’t provide any information to say whether the drug improves quality of life or reduces hospital stays. The authors stress that further research is needed in these areas.
