Top 5 Most-Read Cardiovascular Content of 2024

This year’s top 5 cardiovascular articles explored the approval of new treatments for hypertension and cardiovascular events, the risks associated with high vitamin B₁₂ and xylitol levels, and the benefits of statin therapy for older adults.

Here are the 5 most-viewed cardiovascular pieces of 2024.

5. Statin Therapy Reduces 5-Year CVD Risk in Adults Aged 75 and Older

This May article summarized findings that statin therapy can reduce the 5-year risk of cardiovascular disease (CVD) among patients aged 75 and older without increasing severe adverse event risks. The lipid-lowering, anti-inflammatory, and antioxidative properties of statins make them particularly beneficial for older adults; they help mitigate vascular inflammation and atherosclerosis. Among adults between the ages of 75 and 84, statin therapy reduced CVD risk by 1.2% in the intention-to-treat (ITT) analysis and 5% in the per-protocol (PP) analysis. Among those aged over 85 using statin therapy, CVD risk dropped by 4.44% in the ITT analysis and 12.5% in the PP analysis.

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4. Sugar Substitute Xylitol Linked to Cardiovascular Risk

Higher amounts of the sugar alcohol xylitol are associated with an increased risk of major adverse cardiovascular events (MACE), according to findings covered in a June article. Xylitol is commonly used in sugar-free candy, baked goods, gums, and oral products, like toothpaste. The study included 3 distinct clinical studies with nonoverlapping human participants (n = 1157) and a validation cohort (n = 2149). Higher circulating levels of xylitol in the blood plasma were associated with an increased risk of MACE in both cohorts. However, further studies are needed to assess the long-term safety profile of xylitol.

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3. FDA Approves Semaglutide to Prevent Heart Events in Patients With CVD and Excess Weight

The FDA expanded the approved uses of semaglutide (Wegovy; Novo Nordisk) to include prevention of cardiovascular death, myocardial infarction, and stroke in adult patients with CVD and overweight or obesity. This new indication was granted based on results from the SELECT cardiovascular outcomes trial, which showed that semaglutide reduced MACE risks by 20%. Semaglutide was previously approved in 2014 for chronic weight management in adults with obesity or those overweight who had at least 1 weight-related condition. The eligible population was expanded in 2022 to include pediatric patients 12 years or older with a body mass index of at least the 95^th percentile for their age and sex.

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2. FDA Approves Idorsia’s Tryvio for Resistant Hypertension

In March, the FDA approved aprocitentan (Tryvio; Idorsia) 12.5 mg to treat hypertension in adults when combined with other antihypertensive medications, especially in those whose blood pressure (BP) remains uncontrolled with existing treatment. This was the first oral antihypertensive employing a novel therapeutic pathway approved in nearly 40 years. It received this approval based on results from comprehensive clinical trials, like the phase 3 PRECISION study, which assessed its effectiveness as an add-on therapy in patients with confirmed resistant hypertension. In this trial, aprocitentan showcased superior efficacy in reducing BP and was sustained over an extended period. It also demonstrated efficacy across various patient subgroups, including those with comorbidities and those on multiple antihypertensive medications.

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1. Analysis Says Excessive Vitamin B12 Concentration Can Increase Mortality Risk

This year’s top article explored a positive association between serum vitamin B₁₂ concentration and all-cause mortality risk, especially among older adults. These findings were based on a comprehensive dose-response meta-analysis, which examined 22 cohort studies encompassing 92,346 individuals with 10,704 all-cause deaths. For every 100 pmol/L increase in serum vitamin B₁₂ concentration, there was a 4% higher risk of all-cause mortality in the general population and a 6% higher risk in older adults. The study also associated high serum vitamin B₁₂ levels from supplements in those with concentrations under 200 pmol/L with increased mortality, whereas dietary vitamin B₁₂ did not show the same effect. These findings indicate the need for further research, particularly in understanding the relationship of vitamin B₁₂ with mortality risk across different patient populations and dietary sources.

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