Disease relevance of Primary Prevention

• The potential role of physical activity in the primary prevention of non-insulin-dependent diabetes mellitus (NIDDM) is largely unknown [1].
• Primary prevention of cryptococcal meningitis by fluconazole in HIV-infected patients [2].
• Habitual physical activity and high-density lipoprotein cholesterol in men with primary hypercholesterolemia. The Lipid Research Clinics Coronary Primary Prevention Trial [3].
• Patients completing a prospective, randomized, double-blind, placebo-controlled trial of propranolol for the primary prevention of variceal hemorrhage were tapered off of propranolol and placebo and followed prospectively for subsequent events [4].
• Estrogen is important for the primary prevention of vascular disease in young women, but the mechanisms of protection at the vascular cell are still largely unknown [5].

Psychiatry related information on Primary Prevention

• Increased physical activity may be a promising approach to the primary prevention of NIDDM [6].
• The objective was to identify, in primary prevention, patients whose "required risk reduction" (ReqRR) is greater than the "achievable risk reduction" (ARR) that cholesterol-lowering or antihypertensive medication could provide [7].
• Xenobiotic enzyme inhibitors of NNMT, with or without dietary modification, would be a novel way to attempt primary prevention of PD [8].

High impact information on Primary Prevention

• METHODS: The level of C-reactive protein was measured at base line and after one year in 5742 participants in a five-year randomized trial of lovastatin for the primary prevention of acute coronary events [9].
• Comparison of endoscopic ligation and propranolol for the primary prevention of variceal bleeding [10].
• We conducted a multicenter, randomized, double-blind, placebo-controlled primary prevention trial -- the Beta Carotene and Retinol Efficacy Trial -- involving a total of 18,314 smokers, former smokers, and workers exposed to asbestos [11].
• For primary prevention of P. carinii pneumonia, dapsone-pyrimethamine is as effective, though not as well tolerated, as aerosolized pentamidine [12].
• INTERVENTIONS: Participants in the double-blind primary prevention trial were randomly assigned to receive 40 mg/d of pravastatin (n = 865) or placebo (n = 837) for 24 weeks [13].

Chemical compound and disease context of Primary Prevention

• The first survey was conducted in 1983, before release of the results from the Lipid Research Clinics Coronary Primary Prevention Trial, which showed that a reduction in the blood cholesterol level reduced coronary heart disease; the second survey was conducted in 1986 [14].
• Treating hyperlipidemia for the primary prevention of coronary disease. Are higher dosages of lovastatin cost-effective [15]?
• For primary prevention of vascular disease, treatment of patients with homocysteine levels of 14 micromol/L or higher should be considered [16].
• Supplementation with oral vitamin D3 and calcium during the winter months seems to counteract the effects of seasonal changes in vitamin D and thus may be beneficial as a primary prevention strategy for age-related bone loss [17].
• The changes in serum lipids in men treated with gemfibrozil in the Helsinki Heart Study, a controlled primary prevention trial of coronary heart disease, varied according to baseline lipid levels, type of dyslipidaemia, and treatment compliance [18].

Biological context of Primary Prevention

• A crude analysis of preventable deaths suggests that evidence-based primary prevention (getting the population to stop smoking, exercise, lower cholesterol levels, and control blood pressure) would prevent considerably more deaths per year than would various evidence-based treatments for cardiovascular disease [19].
• Seasonal variation of plasma cholesterol levels was studied in 1446 hypercholesterolemic 35- to 59-year-old male participants in the Lipid Research Clinics Coronary Primary Prevention Trial placebo group [20].
• This review evaluates evidence of the effect of diet on insulin resistance, insulin secretion, and glucose tolerance, and reflects on directions for future work toward primary prevention of type 2 diabetes [21].
• All reports of primary prevention trials using cluster randomization that were published from 1990 to 1993 in the American Journal of Public Health and Preventive Medicine were identified [22].
• In principle, data on the relation between genetic variation in folate metabolism and colorectal neoplasia could be used to corroborate the data on the relation between folate intake or status and the disease, strengthening the evidence base for primary prevention [23].

Anatomical context of Primary Prevention

• For primary prevention of coronary artery disease, physicians and patients often wish to avoid pharmacologic therapy of elevated cholesterol concentrations [24].
• The findings demonstrate that primary prevention of arterial lesions resembling human atherosclerosis (increased amounts of fibrous tissue, smooth muscle cell proliferation, foam cell formation and necrosis at the base of the plaques) results from early effective reduction of elevated plasma lipids by lovastatin in this rabbit strain [25].
• RESULTS: Only 5.5% of participants were on statin treatment for primary prevention, and 16.1% of them had a CHD equivalent, defined as those with clinical manifestations of noncoronary forms of atherosclerotic disease (peripheral arterial disease, abdominal aortic aneurysm, carotid artery disease) and diabetes mellitus [26].

Associations of Primary Prevention with chemical compounds

• We designed a study to determine the efficacy and side effects of inhaled pentamidine in the primary prevention of PCP [27].
• CONCLUSIONS--There is no evidence from primary prevention trials that cholesterol lowering affects total mortality in healthy women, although the available data are limited [28].
• STUDY SELECTION: Five primary prevention placebo-controlled studies, which had been formally pooled, 1 study evaluating secondary prevention of stroke, 1 study comparing warfarin with aspirin, and 3 studies of warfarin in combination with aspirin were identified [29].
• CONCLUSION: These results suggest that intake of folate and vitamin B6 above the current recommended dietary allowance may be important in the primary prevention of CHD among women [30].
• The present study of primary prevention in white men aged 40 to 64 years attempts to investigate whether a beta-blocker given as initial antihypertensive treatment would lower total mortality to a greater extent than thiazide diuretics [31].

Gene context of Primary Prevention

• Using the simple procedure and deriving the estimates of benefit from both primary prevention and therapeutic trials, we obtain an estimated reduction in risk of breast cancer from administration of tamoxifen in BRCA1 mutation positive women of 13% (RR=0.87, 95% CI 0.68--1.11) [32].
• An introduction to aspirin, NSAIDs, and COX-2 inhibitors for the primary prevention of cardiovascular events and cancer and their potential preventive role in bladder carcinogenesis: part I [33].
• Relevance: Evidence indicates that men and women who are susceptible to premenopausal onset of RA can each be identified long before their clinical onsets of disease, and that productive research in primary prevention is an achievable objective [34].
• We investigated whether, in primary prevention patients with metabolic syndrome, statins affect the platelet protease-activated receptor-1 (PAR-1) thrombin receptor by performing serial measurements of its activity and the antigen expression level by flow cytometry before and during treatment [35].
• RESULTS: In the primary prevention trial, compared with placebo, pravastatin reduced median CRP levels by 16.9% (P<.001) at 24 weeks, reflecting a decrease of 0.02 mg/dL in the pravastatin group while no change in CRP levels was observed in the placebo group [13].

Analytical, diagnostic and therapeutic context of Primary Prevention

• Meta-analysis of primary prevention trials in middle-aged men reveal an increase in non-CHD deaths among those randomized to cholesterol interventions, an unexpected finding that is more substantial than the decrease in CHD deaths [36].
• Since some women achieved LDL cholesterol levels low enough to obviate the need for drug therapy as primary prevention of coronary heart disease, dietary therapy should remain the first step in the management of hypercholesterolemia in postmenopausal women [37].
• Subsequent large prospective placebo-controlled clinical trials with statins demonstrated benefit in the secondary and primary prevention of CAD in subjects with elevated cholesterol levels [38].
• BACKGROUND: In primary prevention, anticoagulation with warfarin sodium to an international normalized ratio of 1.5 and 75 mg of aspirin per day each reduced the incidence of coronary heart disease (CHD) [39].
• METHODS: Cord blood was taken from infants at high risk for having asthma and allergic diseases who were recruited for a primary prevention study in which infants were randomized into the intervention or the control group [40].

References