Cardiology Round-Up: Low-Income People Have Worse Cardiac Outcomes, the Dangers of Elderly People Discontinuing Statin Therapy, and More.

Here are the top stories covered by DocWire News this week in the Cardiology section. In this week’s edition of the round-up: people who live in low-income areas have less blood pressure control and worse cardiovascular outcomes, discontinuing statin therapy in elderly people is associated with an increased risk of cardiovascular disease, socioeconomic status is linked with sub-clinical atherosclerosis, and Novartis announces that the PARAGON-HF trial missed its primary endpoint.

People who live in low-income areas experience less blood pressure control and have worse outcomes from adverse cardiovascular events, according to a study published in the Journal of the American Heart Association (JAHA). To conduct this study, researchers evaluated 27,862 participants from 623 clinical sites across the United States, Puerto Rico, the Virgin Islands, and Canada from the Antihypertensive and Lipid‐Lowering Treatment to Prevent Heart Attack (ALLHAT) Trial. According to the study results, low-income participants were less likely to achieve blood pressure control and had higher rates of all‐cause mortality, heart failure hospitalizations/mortality, and end‐stage renal disease, but lower angina hospitalizations and coronary revascularizations. The authors noted that “while medications are the mainstay of hypertension control, there are other factors that we need to pay attention to that are impacting blood pressure control, and the ultimate outcomes we care about – heart disease, stroke, hospitalization and longevity.”

The discontinuation of statin therapy in healthy individuals 75 years of age and older was associated with an increased risk for developing cardiovascular disease. The new study, published in the European Heart Journal, was a survey of 120,173 individuals in France aged 75 or older with no history of cardiovascular disease. The participants had been taking statins for two years prior. According to the results, 17,204 (14.3%) of subjects discontinued statins and 5,396 were admitted for cardiovascular events. Adjusted hazard ratios for statin discontinuation were 1.33 (95% CI, 1.18 to 1.50) for any cardiovascular event, 1.46 (95% CI, 1.21 to 1.75) for coronary events, 1.26 (95% CI, 1.05 to 1.51) for a cerebrovascular event, and 1.02 (95% CI, 0.74 to 1.40) for other vascular events. Dr. Philippe Giral, an endocrinologist specialist in prevention of cardiovascular disease at Pitié-Salpêtrière Hospital in Paris, said in a press release.

Socioeconomic status was associated with sub-clinical atherosclerosis, according to a new study in the Journal of the American College of Cardiology. The analysis out of Spain included 4,025 individuals between 40 and 54 years without known cardiovascular disease from the Progression of Early Subclinical Atherosclerosis (PESA) study. The results suggested that education level was a significant factor associated with the presence of atherosclerosis. The researchers reported no differences due to income level in this patient population. Lower education levels were associated with a higher risk for generalized atherosclerosis compared to those with higher education levels (P=0.002). “Despite the relative economic homogeneity of the cohort, lower education level is associated with increased subclinical atherosclerosis, mainly mediated by the higher and more frequent tobacco consumption,” the authors wrote in their abstract.

The PARAGON-HF trial, evaluating the safety and efficacy of sacubitril/valsartan versus valsartan alone in patients with heart failure with preserved ejection fraction (HFpEF) missed its primary endpoint, according to a Novartis announcement. PARAGON-HF, a double-blind, parallel-group study (n=4,822), represents the largest HFpEF clinical trial conducted to date.  Patients had a history of heart failure hospitalizations and were being treated for HFpEF symptoms and comorbidities. The trial “narrowly missed statistical significance for its composite primary endpoint of reducing cardiovascular death and total heart failure hospitalizations,” according to the press release. They announcement also reported that safety and tolerability were consistent with previous data.