Use of Lifestyle Modifications for Management of a Patient with Severely High Total Cholesterol (> 14 mmol/L) and Triglycerides (> 40 mmol/L).

In this report, we describe a case of a 37-year old man who presented with a history of total cholesterol > 14 mmol/L and triglyceride levels > 40 mmol/L. The patient was initially thought to have familial hypercholesterolemia due to his elevated total cholesterol, by his family physician. He was prescribed evolucumab, a proprotein convertase subtilisin/ kexin type 9 inhibitor drug which has shown efficacy for lowering low-density lipoprotein-cholesterol levels, to reduce his high total cholesterol.

Validation of a patient decision aid for choosing between dabigatran and warfarin for atrial fibrillation.

Background: Decision aids have been helpful to support patients in decision-making including anticoagulation. With the introduction of new oral anticoagulants (NOACs), it will be important to assist patients and physicians in shared decision-making about NOACs and warfarin.

Objectives: To validate a patient decision aid (DA) for warfarin versus dabigatran, the first NOAC approved for atrial fibrillation (AF).

Shared electronic vascular risk decision support in primary care: Computerization of Medical Practices for the Enhancement of Therapeutic Effectiveness (COMPETE III) randomized trial.

Background: Computerized decision support systems (CDSSs) linked with electronic medical records (EMRs) are promoted as an effective means of improving patient care. However, very few high-quality studies are set in routine, community-based clinical care, and no consistent evidence of an effect on patient outcomes has been found.

Methods: A randomized controlled trial among EMR-using primary care practices in Ontario, Canada.

Determinants of masked hypertension in hypertensive patients treated in a primary care setting.

Background: Recent data suggest that masked hypertension (MH) carries a cardiovascular risk similar to that of uncontrolled hypertension.

Aims: The objective of this study was to determine the prevalence and determinants of MH in patients treated for hypertension in a Canadian primary care setting.

Methods: Office blood pressure (OBP) was measured at baseline and after 3 months of valsartan-based therapy in 5636 hypertensive patients who had recorded their home blood pressure monitoring (HBPM) for seven consecutive days at month 3 using an Omron HEM-711 apparatus.

Reaching the therapeutic goal in hypertension: results from the Canadian valsartan observational study. (Diovantage 4).

Background: Hypertension is a leading cause of death worldwide, and a major public health problem in Canada. Despite treatment guidelines and availability of therapies for blood pressure (BP) management, treatment of hypertension remains sub-optimal.

Objectives: The objectives of this trial are to observe BP reduction, compliance and regimen changes 3 months after initiation of valsartan alone or with hydrochlorothiazide and optimized patient support.

AVAPROMISE: A randomized clinical trial for increasing adherence through behavioural modification in essential hypertension.

Background: Patients with hypertension often do not adhere to their medications.

Objective: To improve medication adherence in patients with essential hypertension by modifying their behaviours.

Patients And Methods: From general practice settings, 4864 patients with essential hypertension were recruited and randomly assigned to receive the angiotensin receptor blocker irbesartan (Avapro) with (intervention group) or without (nonintervention group) a behavioural modification program (Avapromise) based on a model of change.

Comparison of the short term efficacy and tolerability of lovastatin and simvastatin in the management of primary hypercholesterolemia.

Objectives: To compare the safety and efficacy of lovastatin and simvastatin in patients with primary hypercholesterolemia.

Methods: Fourteen Canadian centres participated in this double-blind, randomized, parallel-design study with a six-week screening period, a four-week placebo baseline period and an 18-week active treatment period. Patients were included in the study if their total cholesterol (TC) was at least 6.

Comparison of the short-term efficacy and tolerability of lovastatin and pravastatin in the management of primary hypercholesterolemia.

Few data are available on the relative efficacy and tolerability of lovastatin and pravastatin, two 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors, currently available in North America for treatment of hypercholesterolemia. The recommended starting dose is 20 mg QD with the evening meal for lovastatin. The recommended starting dose is 10 mg or 20 mg once daily at bedtime for pravastatin.