Article Impact Level: HIGH Data Quality: STRONG Summary of BMC Medicine, 22(1), 353. https://doi.org/10.1186/s12916-024-03577-8 Dr. Emma L. Connolly et al.
Points
- A randomized, controlled trial found that increased intake of cruciferous vegetables significantly reduced 24-hour systolic blood pressure (SBP) in Australian adults with mildly elevated blood pressure.
- Eighteen participants consumed approximately 300 g/day of either cruciferous vegetables or root and squash vegetables for two weeks, with a two-week washout.
- The cruciferous vegetable intervention led to a mean SBP reduction of 2.5 mmHg, primarily driven by daytime SBP reductions (–3.6 mmHg).
- Serum triglycerides were also significantly lower after the cruciferous vegetable intake compared to the control group.
- The findings suggest that cruciferous vegetables offer cardiovascular benefits, potentially supporting targeted dietary recommendations for managing hypertension.
Summary
A recent study assessed statin therapy’s long-term effects and cost-effectiveness in adults aged 70 years and older within the contemporary UK population. Recognizing that cardiovascular disease (CVD) risk escalates with age and that the efficacy of statins in older individuals remains uncertain, researchers utilized a newly validated cardiovascular disease microsimulation model. This model was developed using Cholesterol Treatment Trialists’ Collaboration (CTTC) data and the UK Biobank cohort. The study evaluated participants from the UK Biobank and the Whitehall II studies, totaling 15,019 individuals without prior CVD and 5,103 with prior CVD, all aged ≥70 years. The model projected cardiovascular risks, survival rates, quality-adjusted life years (QALYs), and healthcare costs with and without lifetime use of standard (35%–45% LDL cholesterol reduction) or higher-intensity (≥45% LDL cholesterol reduction) statin therapy.
The results indicated that lifetime use of standard statin therapy increased QALYs by 0.24 to 0.70 per person among men and women aged ≥70 years, regardless of prior CVD status. Higher-intensity statin therapy provided an additional increase of 0.04 to 0.13 QALYs per person. Cost-effectiveness analysis revealed that statin therapies were economically favorable, with an incremental cost per QALY gained below £3,502 for standard therapy and below £11,778 for higher-intensity therapy. These figures demonstrate a high probability of cost-effectiveness. Sensitivity analyses, which accounted for smaller CVD risk reductions and hypothetical additional adverse effects of statins, confirmed that statins remained cost-effective. However, there was more significant uncertainty among older individuals without prior CVD.
The study concludes that, based on current evidence and modeling analyses, statin therapy improves health outcomes cost-effectively for men and women aged ≥70 years. These findings support the use of statins for both primary and secondary prevention of CVD in older adults. Clinicians should consider prescribing statin therapy to elderly patients to reduce cardiovascular events and enhance quality-adjusted life expectancy, as the benefits outweigh the costs even when accounting for potential risks.
Link to the article: https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-024-03577-8
References Connolly, E. L., Liu, A. H., Radavelli-Bagatini, S., Shafaei, A., Boyce, M. C., Wood, L. G., McCahon, L., Koch, H., Sim, M., Hill, C. R., Parmenter, B. H., Bondonno, N. P., Devine, A., Croft, K. D., Mithen, R., Gan, S. K., Schultz, C. J., Woodman, R. J., Bondonno, C. P., … Blekkenhorst, L. C. (2024). Cruciferous vegetables lower blood pressure in adults with mildly elevated blood pressure in a randomized, controlled, crossover trial: The VEgetableS for vaScular hEaLth (VESSEL) study. BMC Medicine, 22(1), 353. https://doi.org/10.1186/s12916-024-03577-8
