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This guideline updates for primary prevention, the NICE technology appraisal, ‘Statins for the prevention of cardiovascular events’ (TA94, 2007) and reviews and updates the recommendations made in the NICE guideline Lipid Modification (CG67, 2008) for primary and secondary prevention of cardiovascular disease (CVD). The scope for this guideline was limited to the identification and assessment of CVD risk and to the assessment and modification of lipids in people at risk of CVD, or people with known CVD. The guideline development group wishes to make clear that lipid modification should take place as part of a programme of risk reduction which also include attention to the management of all other known CVD risk factors.

NICE Clinical Guidelines - National Clinical Guideline Centre (UK).

Version: July 2014

While the NHS in England and Wales has made spectacular progress in improving the secondary prevention of cardiovascular disease, we now need to work harder to identify those who are at particularly high risk of myocardial infarction.

NICE Clinical Guidelines - National Collaborating Centre for Primary Care (UK).

Version: August 2008

Familial hypercholesterolemia (FH) is an inherited disorder of lipoprotein metabolism characterized by highly elevated total cholesterol (TC) concentrations early in life, independent of environmental influences. Around 1 in 200 to 1 in 500 persons in North America and Europe are estimated to have heterozygous FH. When untreated, FH is associated with a high incidence of premature clinical atherosclerotic cardiovascular disease.

Evidence Syntheses - Agency for Healthcare Research and Quality (US).

Version: August 2016

This report evaluates the current state of evidence regarding effectiveness and harms of noninvasive technologies for the diagnosis of coronary artery disease (CAD) or dysfunction that results in symptoms attributable to myocardial ischemia in stable symptomatic patients who have no known history of CAD.

Comparative Effectiveness Reviews - Agency for Healthcare Research and Quality (US).

Version: March 2016

We conducted this systematic review to support the U.S. Preventive Services Task Force (USPSTF) in updating its recommendation on screening for cognitive impairment in older adults. Our review addresses five questions: 1) Does screening for cognitive impairment in community-dwelling older adults improve decisionmaking, patient, family/caregiver, or societal outcomes?; 2) What is the test performance of screening instruments to detect dementia or mild cognitive impairment (MCI) in community-dwelling older adult primary care patients?; 3) What are the harms of screening for cognitive impairment?; 4) Do interventions for early dementia or MCI in older adults improve decisionmaking, patient, family/caregiver, or societal outcomes?; and 5) What are the harms of interventions for cognitive impairment?

Evidence Syntheses - Agency for Healthcare Research and Quality (US).

Version: November 2013

This review assessed evidence for interventions aimed at preventing or delaying the onset of age-related cognitive decline, mild cognitive impairment (MCI), or clinical Alzheimer’s-type dementia (CATD).

Comparative Effectiveness Reviews - Agency for Healthcare Research and Quality (US).

Version: March 2017

Atrial fibrillation (AF) is a very common problem. In England alone, approximately 835,000 people have AF.321 Through its effects on rate and rhythm, it is a major cause of morbidity. Through increasing susceptibility to stroke, it is a major cause of both morbidity and mortality.

NICE Clinical Guidelines - National Clinical Guideline Centre (UK).

Version: June 2014

This guideline covers interventions in the acute stage of a stroke (‘acute stroke’) or transient ischaemic attack (TIA). Most of the evidence considered relates to interventions in the first 48 hours after onset of symptoms, although some interventions of up to 2 weeks are covered as well. This guideline is a stand-alone document, but is designed to be read alongside the Intercollegiate Stroke Working Party guideline ‘National clinical guideline for stroke’ which considers evidence for interventions from the acute stage into rehabilitation and life after stroke. The Intercollegiate Stroke Working Party guideline is an update of the 2004 2nd edition and includes all the recommendations contained within this guideline. This acute stroke and TIA guideline is also designed to be read alongside the Department of Health’s (DH) ‘National stroke strategy’ (NSS). Where there are differences between the recommendations made within this acute stroke and TIA guideline and the NSS, the Guideline Development Group (GDG) members feel that their recommendations are derived from systematic methodology to identify all of the relevant literature.

NICE Clinical Guidelines - National Collaborating Centre for Chronic Conditions (UK).

Version: 2008

This study found evidence to support the use of annual screening to identify the development of early kidney disease in patients with diabetes, which is consistent with current UK guidelines. For type 1 diabetes, the costs of annual screening are well within the accepted level of cost-effectiveness, and, for patients with type 2 diabetes, annual screening is even more cost-effective.

Health Technology Assessment - NIHR Journals Library.

Version: February 2014

The study found that it is feasible to address several of the important problems faced by guideline developers when attempting to account for multimorbidity.

Health Services and Delivery Research - NIHR Journals Library.

Version: April 2017

Type 1 diabetes affects over 370,000 adults in the UK, representing approximately 10% of adults diagnosed with diabetes. Given the complexity of its treatment regimens, successful outcomes depend, perhaps more than with any other long-term condition, on full engagement of the adult with type 1 diabetes in life-long day-by-day self-management. In order to support this, the health service needs to provide informed, expert support, education and training as well as a range of other more conventional biomedical services and interventionsfor the prevention and management of long term complications and disability.

NICE Guideline - National Clinical Guideline Centre (UK).

Version: August 2015

There are 2 thiazolidinediones approved for prescription use in the United States, rosiglitazone maleate (Avandia™) and pioglitazone hydrochloride (Actos®). Both drugs are approved by the United States Food and Drug Administration for use in adults for the treatment of type 2 diabetes, either as monotherapy or in combination with insulin, metformin, or sulfonylurea when diet, exercise, and a single agent does not result in adequate glycemic control. Neither drug is currently approved for use in prediabetes or the metabolic syndrome. The objective of this review was to compare thiazolidinediones in the treatment of type 2 diabetes, prediabetes, and the metabolic syndrome.

Drug Class Reviews - Oregon Health & Science University.

Version: August 2008

Although dapagliflozin, canagliflozin and empagliflozin improve glycaemic control, as monotherapy they are not cost-effective compared with gliclazide or pioglitazone, but may be against sitagliptin.

Health Technology Assessment - NIHR Journals Library.

Version: January 2017

Treatment options for atherosclerotic renal artery stenosis (ARAS) include medical therapy alone or renal artery revascularization with continued medical therapy, most commonly by percutaneous transluminal renal angioplasty with stent placement (PTRAS). This review updates a prior Comparative Effectiveness Review of management strategies for ARAS from 2006, which was updated in 2007.

Comparative Effectiveness Reviews - Agency for Healthcare Research and Quality (US).

Version: August 2016

The study found evidence to suggest that integrated continuous glucose monitoring insulin pump therapy systems are more clinically effective in patients with type 1 diabetes than stand-alone treatments. However, based on the evidence available, these integrated systems are unlikely to be cost-effective in comparison with stand-alone insulin delivery and monitoring. Further research on the clinical effectiveness and cost-effectiveness of these integrated systems in different populations is warranted.

Health Technology Assessment - NIHR Journals Library.

Version: February 2016

While in its early years the HIV epidemic affected primarily the male and the young, nowadays the population living with HIV/AIDS comprises approximately 24 percent women, and its age composition has shifted towards older ages. Many women over 40 who live with HIV/AIDS also live with the medical and social conditions that accompany aging.

Technical Briefs - Agency for Healthcare Research and Quality (US).

Version: November 2016

To evaluate the comparative effectiveness of interventions (intravenous [IV] fluids, N-acetylcysteine, sodium bicarbonate, and statins, among others) to reduce the risk of contrast-induced nephropathy (CIN), need for renal replacement therapy, mortality, cardiac complications, prolonged length of stay, and other adverse events after receiving low-osmolar contrast media (LOCM) or iso-osmolar contrast media (IOCM).

Comparative Effectiveness Reviews - Agency for Healthcare Research and Quality (US).

Version: January 2016

Multimorbidity is usually defined as when an individual has two or more long-term conditions. Measuring the prevalence of multimorbidity is not straightforward since this will vary depending on which conditions are counted, but all recent studies show that multimorbidity is common, becomes more common as people age, and is more common in people from less affluent areas. A recent large UK based study found that 42% of the population had at least one of the 40 conditions counted, and 23% had multimorbidity. Two-thirds of people aged 65 years or over had multimorbidity, and 47% had three or more conditions. People living in the most deprived areas had double the rate of multimorbidity in middle age than those living in the most affluent areas. Put another way, they developed multimorbidity 10-15 years before their more affluent peers. The recognition of multimorbidity associated with socioeconomic depreivation is particularly important as NHS England has a legal duty to have regard to the need to reduce health inequalities. Whereas rates of multimorbidity in older people was largely due to higher rates of physical conditions, in the less affluent multimorbidity was due to combinations of physical and mental health conditions was common.

NICE Guideline - National Guideline Centre (UK).

Version: September 2016

In the United States, coronary heart disease and cardiovascular disease account for nearly 40% of deaths each year. An individual’s estimated risk for coronary heart disease events, often based on factors incorporated into the Framingham risk score, guides the intensity of risk reduction interventions. We conducted a systematic review of epidemiologic studies to help the U.S. Preventive Services Task Force determine which, if any, of 9 additional risk factors should be considered for incorporation into guidelines for coronary and cardiovascular risk assessment in primary care.

Evidence Syntheses - Agency for Healthcare Research and Quality (US).

Version: October 2009

Clinical guidelines have been defined as ‘systematically developed statements which assist clinicians and patients in making decisions about appropriate treatment for specific conditions’. This clinical guideline concerns the management of diabetes and its complications from preconception to the postnatal period. It has been developed with the aim of providing guidance on:

NICE Guideline - National Collaborating Centre for Women's and Children's Health (UK).

Version: February 2015

Systematic Reviews in PubMed

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