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Varenicline: no link with cardiovascular events found in meta-analysis

18 May, 12 | by Alistair Lindsay

Varenicline (Champix) is a partial agonist to nicotine receptors, and is approved for smoking cessation therapy. However, the FDA has raised concern about a possible increase in the incidence of cardiovascular events of patients taking the drug in randomised trials. In this meta-analysis, Prochaska et al. looked at 22 randomised controlled trials of current tobacco users and compared cardiovascular events in those given varenicline compared to those given placebo. Cardiovascular adverse events were defined if they occurred during drug treatment or within 30 days of discontinuation. All the trials included in the analysis were double blind and placebo controlled, and two included participants with active cardiovascular disease, while eleven enrolled patients with a history of cardiovascular disease. Rates of cardiovascular serious adverse events were 0.63% in the varenicline groups and 0.47% in the placebo groups. The summary estimate for the risk difference (0.27%, P=0.15) was not significant either clinically or statistically. more…

Clarifying the role of nicotine in weight control

12 Jul, 11 | by Alistair Lindsay

Despite the impressive gains in cardiovascular morbidity and mortality that have occurred over the past decades, a veritable elephant still exists in the room in the shape of the tidal wave of obesity sweeping the globe, which may reverse these advances.  Obesity has proved fundamentally difficult to manage, with few therapies demonstrating sustained weight loss over time be they pharmacological or behavioural.  Paradoxically, that other great modifiable risk factor for cardiovascular disease, smoking, is highly effective at controlling weight, with smokers having notably lower BMIs than non-smokers, some smokers smoking as a method of weight control and weight gain being common when quitting.  These anorexic effects have been attributed to nicotine as it effectively decreases feeding in animal models, but while nicotine has some effect on peripheral energy metabolism, little is known about its effect on central pathways determining food intake and body mass. more…

Smoking cessation provides rapid vascular benefit

18 Jul, 08 | by Alistair Lindsay

A causal relationship between smoking and cardiovascular death is well established. But, for those patients who successfully stop smoking, are the detrimental effects fully reversible? And if so, how quickly do the benefits become apparent? more…

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