Placebo Use in Clinical Trials May Cause Problems in Patients With Pulmonary Hypertension
A new study shows that patients with pulmonary hypertension who receive a placebo during a clinical trial may experience clinical deterioration. Researchers from Dwight David Eisenhower Army Medical Center in Georgia conducted a meta-analysis of 13 randomized, placebo-controlled clinical trials that included a total of 1,999 patients with pulmonary hypertension. Of the patients, 1,131 were treated with a study drug, while 868 were treated with placebo. The analysis showed that placebo-treated patients were 1.81 times more likely to suffer a clinical worsening, including a decline in pulmonary hemodynamic parameters and a decrease in 6-minute walk distance. Placebo treatment was not associated with a difference in mortality. Researchers suggest future studies involving patients with pulmonary hypertension should focus on evaluating existing medications against one another and comparing novel therapies with those currently accepted. This study appears in the September issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.
Asthma Medication May Lower Risk of Cardiovascular Disease
The use of some asthma medications may lower the risk of cardiovascular disease in patients with asthma, shows a new study from the University of Southern California. Researchers measured cardiovascular disease (CVD) inflammatory biomarkers and lipid levels in 161 patients receiving theophylline, 164 patients receiving montelukast, and 164 patients receiving a placebo. Serum levels of C-reactive protein (CRP), interleukin-6, total cholesterol, triglycerides, low-density lipoprotein cholesterol, and high-density cholesterol were measured at 1 month and 6 months after treatment. Patients with moderate to severe asthma receiving montelukast had significantly lower serum CRP and lipid levels compared to placebo at both time points. Lipid levels also were significantly lower in the theophylline group compared with placebo in patients using inhaled corticosteroids. Researchers conclude that these asthma medications may have some beneficial value in patients with asthma in respect to CVD risk. This study appears in the September issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.
CPAP Use for Sleep Apnea May Lower Patient's Cardiovascular Risk
Continuous positive airway pressure (CPAP), when used on a consistent basis for managing sleep apnea, may reduce a patient's risk for cardiovascular disease. Researchers from Greece measured serum cardiovascular risk factors at baseline and at 6 months after CPAP usage in 53 nonsmoking patients, newly diagnosed with sleep apnea. Patients were classified based on CPAP compliance: good compliance (n=20), poor compliance (n=19), and refusal of CPAP (n=14). Patients with good CPAP compliance showed significant decreases in most cardiovascular risk factors. Patients with poor compliance showed a decrease in one cardiovascular risk area, while the patients who refused CPAP experienced no significant changes. Researchers conclude that good CPAP compliance may have a beneficial effect on overall cardiovascular risk. This study appears in the September issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.