Aripiprazole/Sertraline Combination: Clinical and Cost-Effectiveness in Comparison With Quetiapine for the Treatment of Bipolar Depression (ASCEnD Trial)-Protocol for a Nested Qualitative Study.

Introduction: Bipolar disorder is a recurrent mental health disorder with a prevalence rate of 1.4%. On average, there can be a delay of 9.

Treatment and outcomes of acute coronary syndromes in women: An analysis of a multicenter quality improvement Chinese study.

Background: Variations in care and outcomes by sex in patients with acute coronary syndrome (ACS) have been reported worldwide. The aims of this study are to describe ACS management according to sex in China and the effects of a quality improvement program in Chinese male and female ACS patients.

Methods And Results: Clinical Pathways for Acute Coronary Syndromes - Phase 2 (CPACS-2) was a cluster randomized trial to test whether a clinical pathways-based intervention would improve ACS management in China.

Effects of intensive blood pressure lowering on cardiovascular and renal outcomes: updated systematic review and meta-analysis.

Background: Recent hypertension guidelines have reversed previous recommendations for lower blood pressure targets in high-risk patients, such as those with cardiovascular disease, renal disease, or diabetes. This change represents uncertainty about whether more intensive blood pressure-lowering strategies are associated with greater reductions in risk of major cardiovascular and renal events. We aimed to assess the efficacy and safety of intensive blood pressure-lowering strategies.

Rational and design of a stepped-wedge cluster randomized trial evaluating quality improvement initiative for reducing cardiovascular events among patients with acute coronary syndromes in resource-constrained hospitals in China.

Background: Acute coronary syndromes (ACSs) are a major cause of morbidity and mortality, yet effective ACS treatments are frequently underused in clinical practice. Randomized trials including the CPACS-2 study suggest that quality improvement initiatives can increase the use of effective treatments, but whether such programs can impact hard clinical outcomes has never been demonstrated in a well-powered randomized controlled trial.

Design: The CPACS-3 study is a stepped-wedge cluster-randomized trial conducted in 104 remote level 2 hospitals without PCI facilities in China.

Effects of blood pressure reduction in mild hypertension: a systematic review and meta-analysis.

Background: Effects of blood pressure reduction in persons with grade 1 hypertension are unclear.

Purpose: To investigate whether pharmacologic blood pressure reduction prevents cardiovascular events and deaths in persons with grade 1 hypertension.

Data Sources: Trials included in the BPLTTC (Blood Pressure Lowering Treatment Trialists' Collaboration) and trials identified from a previous review and electronic database searches.

Prescription of secondary prevention medications, lifestyle advice, and referral to rehabilitation among acute coronary syndrome inpatients: results from a large prospective audit in Australia and New Zealand.

Objective: To evaluate the proportion of patients hospitalised with acute coronary syndrome (ACS) in Australia and New Zealand who received optimal inpatient preventive care and to identify factors associated with preventive care.

Methods: All patients hospitalised bi-nationally with ACS were identified between 14-27 May 2012. Optimal in-hospital preventive care was defined as having received lifestyle advice, referral to rehabilitation, and prescription of secondary prevention pharmacotherapies.

Hospital quality improvement initiative for patients with acute coronary syndromes in China: a cluster randomized, controlled trial.

Background- Substantial evidence-practice gaps exist in the management of acute coronary syndromes (ACS) in China. Clinical pathways are tools for improving ACS quality of care but have not been rigorously evaluated. Methods and Results- Between October 2007 and August 2010, a quality improvement program was conducted in 75 hospitals throughout China with mixed methods evaluation in a cluster randomized, controlled trial.

System barriers to the evidence-based care of acute coronary syndrome patients in China: qualitative analysis.

Background: Organizational and wider health system factors influence the implementation and success of interventions. Clinical Pathways in Acute Coronary Syndromes 2 is a cluster randomized trial of a clinical pathway-based intervention to improve acute coronary syndrome care in hospitals in China. We performed a qualitative evaluation to examine the system-level barriers to implementing clinical pathways in the dynamic healthcare environment of China.

Acute coronary syndrome care across Australia and New Zealand: the SNAPSHOT ACS study.

Objectives: To characterise management of suspected acute coronary syndrome (ACS) in Australia and New Zealand, and to assess the application of recommended therapies according to published guidelines.

Design, Setting And Patients: All patients hospitalised with suspected or confirmed ACS between 14 and 27 May 2012 were enrolled from participating sites in Australia and New Zealand, which were identified through public records and health networks. Descriptive and logistic regression analysis was performed.

Effects of intensive blood pressure lowering on cardiovascular and renal outcomes: a systematic review and meta-analysis.

Background: Guidelines recommend intensive blood pressure (BP) lowering in patients at high risk. While placebo-controlled trials have demonstrated 22% reductions in coronary heart disease (CHD) and stroke associated with a 10-mmHg difference in systolic BP, it is unclear if more intensive BP lowering strategies are associated with greater reductions in risk of CHD and stroke. We did a systematic review to assess the effects of intensive BP lowering on vascular, eye, and renal outcomes.

Comparative effectiveness of population interventions to improve access to reperfusion for ST-segment-elevation myocardial infarction in Australia.

Background: Improving timely access to reperfusion is a major goal of ST-segment-elevation myocardial infarction care. We sought to compare the population impact of interventions proposed to improve timely access to reperfusion therapy in Australia.

Methods And Results: Australian hospitals, population, and road network data were integrated using Geographical Information Systems.

Opinions of community pharmacists on the value of a cardiovascular polypill as a means of improving medication compliance.

Objective: Cardiovascular disease is a major public health problem despite established treatment guidelines and significant healthcare expenditure worldwide. Poor medication compliance accounts in part for some of the observed evidence/practice gaps. Trials of fixed-dose combination pills are currently underway, but the attitudes of relevant health professionals to the routine use of a cardiovascular polypill are generally unknown.

Gender disparities in the assessment and management of cardiovascular risk in primary care: the AusHEART study.

Aims: Studies indicate ongoing gender-based differences in the prevention, detection and management of cardiovascular disease. The aims of this study were to determine whether there are differences in general practitioners' (GPs') perceptions of a patient's cardiovascular risk compared with the patient's estimated risk and in the patient's subsequent medical management according to patient sex.

Methods: The Australian Hypertension and Absolute Risk Study (AusHEART) was a nationally representative, cluster-stratified, cross-sectional survey among 322 GPs.

The effects of blood pressure reduction and of different blood pressure-lowering regimens on major cardiovascular events according to baseline blood pressure: meta-analysis of randomized trials.

Background: The benefits of reducing blood pressure are well established, but there remains uncertainty about whether the magnitude of the effect varies with the initial blood pressure level. The objective was to compare the risk reductions achieved by different blood pressure-lowering regimens among individuals with different baseline blood pressures.

Methods: Thirty-two randomized controlled trials were included and seven comparisons between different types of treatments were made.

Aspirin is beneficial in hypertensive patients with chronic kidney disease: a post-hoc subgroup analysis of a randomized controlled trial.

Objectives: The purpose of this study was to determine the benefit and risk associated with antiplatelet therapy in the chronic kidney disease (CKD) population.

Background: Cardiovascular and possibly bleeding risks are elevated in patients with CKD. The balance of benefit and harm associated with antiplatelet therapy remains uncertain.

Clinical pathways for acute coronary syndromes in China: protocol for a hospital quality improvement initiative.

Clinical pathways have been shown to be effective in improving quality of care for patients admitted to hospital for acute coronary syndromes (ACS) in high-income countries. However, their utility has not formally been evaluated in low- or middle-income countries. The Clinical Pathways for Acute Coronary Syndromes in China program is a 7-year study with the overall goal of reducing evidence-practice gaps in the management of patients admitted to hospitals in China with suspected ACS.

The Framingham Study, diabetes mellitus and cardiovascular disease: turning back the clock.

The global population of individuals with diabetes is important and rapidly growing. Because of the link between diabetes and cardiovascular disease (CVD), it is expected that diabetes will be an important driver of the future burden of CVD around the world. A connection between diabetes and CVD was suspected as earlier as in the mid 19th century.

Blood pressure and cardiovascular disease: tracing the steps from Framingham.

Around one-quarter of the world's adult population are defined as "hypertensive" however a much greater proportion are at risk of blood pressure-related disease because of the nature of the association between blood pressure and cardiovascular risk. The Framingham Study, together with other landmark observational studies, has been instrumental in elucidating this relationship. As early as the 1960s, Framingham showed that the association between blood pressure and cardiovascular risk was continuous and linear and was consistent across different age groups and for a range of major cardiovascular events.

Effectiveness of blood pressure lowering: evidence-based comparisons between men and women.

The global burden of blood pressure-related disease is escalating faster among women than among men and, in recent years, age-adjusted mortality rates among women have actually increased. This has led to the speculation that there might be major sex-specific differences in the effectiveness of preventive therapies such as blood pressure-lowering drugs. However, large overviews of both observational and clinical trial data provide strong evidence that the protection against serious vascular events afforded by blood pressure reduction using a range of commonly used drugs is comparable for men and women.

An electronic clinical decision support tool to assist primary care providers in cardiovascular disease risk management: development and mixed methods evaluation.

Background: Challenges remain in translating the well-established evidence for management of cardiovascular disease (CVD) risk into clinical practice. Although electronic clinical decision support (CDS) systems are known to improve practitioner performance, their development in Australian primary health care settings is limited.

Objectives: Study aims were to (1) develop a valid CDS tool that assists Australian general practitioners (GPs) in global CVD risk management, and (2) preliminarily evaluate its acceptability to GPs as a point-of-care resource for both general and underserved populations.

Evidence-based medication use among Chinese patients with acute coronary syndromes at the time of hospital discharge and 1 year after hospitalization: results from the Clinical Pathways for Acute Coronary Syndromes in China (CPACS) study.

Background: Coronary heart disease has emerged as a leading cause of death in China. Although there is strong evidence for the use of antiplatelet, blood pressure-lowering, and lipid-lowering therapy in patients with acute coronary syndromes, the extent to which these medications are used in China remains uncertain.

Methods: We conducted a multicenter prospective study using data from consecutive patients diagnosed with suspected acute myocardial infarction or unstable angina pectoris admitted to the inpatient wards during the recruitment period.