SynthesisHealth technology assessment (Winchester, England)2025
Determining optimal strategies for primary prevention of cardiovascular disease: a synopsis of an evidence synthesis study.
Synthesis in Health technology assessment (Winchester, England), 2025. The graph read 7 numbers from its abstract, feeding 5 cells of the map, but none could be read as for or against, so it casts no vote. It also reports 3 associations that do not count as treatment evidence, such as RR 0.81 (0.71 to 0.91) for composite cardiovascular disease events and mortality. Cited by 2 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
Read, but not usablea number the graph found but could not read as for or against
The network meta-analysis found that antihypertensives (relative risk 0.76, 95% confidence interval 0.64 to 0.90), intensive blood pressure control (relative risk 0.66, 95% confidence interval 0.46 to 0.96), statins (relative risk 0.81, 95% confidence interval 0.71 to 0.91) and multifactorial lifestyle interventions (relative risk 0.75, 95% confidence interval 0.61 to 0.92) significantly reduced composite cardiovascular disease events and mortality.
The network meta-analysis found that antihypertensives (relative risk 0.76, 95% confidence interval 0.64 to 0.90), intensive blood pressure control (relative risk 0.66, 95% confidence interval 0.46 to 0.96), statins (relative risk 0.81, 95% confidence interval 0.71 to 0.91) and multifactorial lifestyle interventions (relative risk 0.75, 95% confidence interval 0.61 to 0.92) significantly reduced composite cardiovascular disease events and mortality.
The network meta-analysis found that antihypertensives (relative risk 0.76, 95% confidence interval 0.64 to 0.90), intensive blood pressure control (relative risk 0.66, 95% confidence interval 0.46 to 0.96), statins (relative risk 0.81, 95% confidence interval 0.71 to 0.91) and multifactorial lifestyle interventions (relative risk 0.75, 95% confidence interval 0.61 to 0.92) significantly reduced composite cardiovascular disease events and mortality.
Results: The umbrella review found that antiplatelets reduced major cardiovascular disease events in 8/17 meta-analyses (relative risks 0.85-0.97), while statins reduced cardiovascular disease mortality (relative risks 0.71-0.89), all-cause mortality (relative risks 0.66-0.93) and major cardiovascular disease events (relative risks 0.59-0.90). sodium-glucose transport protein 2 inhibitors reduced major cardiovascular disease events by 8% (relative risk 0.92, 95% confidence interval 0.89 to 0.95) and all-cause mortality by 6% (relative risk 0.94, 95% confidence interval 0.90 to 0.98).
Results: The umbrella review found that antiplatelets reduced major cardiovascular disease events in 8/17 meta-analyses (relative risks 0.85-0.97), while statins reduced cardiovascular disease mortality (relative risks 0.71-0.89), all-cause mortality (relative risks 0.66-0.93) and major cardiovascular disease events (relative risks 0.59-0.90). sodium-glucose transport protein 2 inhibitors reduced major cardiovascular disease events by 8% (relative risk 0.92, 95% confidence interval 0.89 to 0.95) and all-cause mortality by 6% (relative risk 0.94, 95% confidence interval 0.90 to 0.98).
Results: The umbrella review found that antiplatelets reduced major cardiovascular disease events in 8/17 meta-analyses (relative risks 0.85-0.97), while statins reduced cardiovascular disease mortality (relative risks 0.71-0.89), all-cause mortality (relative risks 0.66-0.93) and major cardiovascular disease events (relative risks 0.59-0.90). sodium-glucose transport protein 2 inhibitors reduced major cardiovascular disease events by 8% (relative risk 0.92, 95% confidence interval 0.89 to 0.95) and all-cause mortality by 6% (relative risk 0.94, 95% confidence interval 0.90 to 0.98).
Results: The umbrella review found that antiplatelets reduced major cardiovascular disease events in 8/17 meta-analyses (relative risks 0.85-0.97), while statins reduced cardiovascular disease mortality (relative risks 0.71-0.89), all-cause mortality (relative risks 0.66-0.93) and major cardiovascular disease events (relative risks 0.59-0.90). sodium-glucose transport protein 2 inhibitors reduced major cardiovascular disease events by 8% (relative risk 0.92, 95% confidence interval 0.89 to 0.95) and all-cause mortality by 6% (relative risk 0.94, 95% confidence interval 0.90 to 0.98).
clause the extractor read what became the number
Where it lands on the map
Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.
What it adds to each cell
For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.
Antihypertensives×all-cause mortality
No readable resultOpen on the map →What to test next →No other readable study in this cell yet. This paper is the evidence.
Antiplatelet & anticoagulant×adverse events & safety
No readable resultOpen on the map →What to test next →1 readable study in this cell: 0 favour the treatment, 1 find no difference, 0 favour the comparator.
This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.
Diet, exercise & lifestyle×all-cause mortality
No readable resultOpen on the map →What to test next →1 readable study in this cell: 0 favour the treatment, 1 find no difference, 0 favour the comparator.
This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.
Statins×all-cause mortality
No readable resultOpen on the map →What to test next →13 readable studies in this cell: 3 favour the treatment, 8 find no difference, 2 favour the comparator.
This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.
Statins×adverse events & safety
No readable resultOpen on the map →What to test next →11 readable studies in this cell: 3 favour the treatment, 7 find no difference, 1 favour the comparator.
This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- Towards precision medicine in Tourette syndrome: a perspective on AI-driven predictive modelling and personalised care.Frontiers in computational neuroscience · 2026Review
- Summary of the best evidence for non-pharmacological interventions for dyslipidemia in patients with coronary heart disease.Frontiers in cardiovascular medicine · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The marked sentences are the ones the graph read a number from.
Background: Cardiovascular disease remains a leading cause of morbidity and mortality worldwide. This series of systematic reviews and meta-analyses synthesised evidence on the effectiveness, comparative effectiveness and cost-effectiveness of pharmacological and non-pharmacological interventions for primary cardiovascular disease prevention. Methods: Five systematic reviews and meta-analyses were conducted using rigorous methods, including comprehensive searches, duplicate screening, risk-of-bias assessments and adherence to reporting guidelines. An umbrella review summarised evidence from 95 systematic reviews. A machine learning study developed a parallel Convolutional Neural Network algorithm with 96.4% recall and 99.1% precision for study screening. A network meta-analysis compared preventive strategies across 139 trials (1,053,772 participants). Simulation modelling projected the population impact of policy interventions, and a cost-effectiveness review appraised eight United Kingdom-based economic evaluations. Results: The umbrella review found that antiplatelets reduced major cardiovascular disease events in 8/17 meta-analyses (relative risks 0.85-0.97), while statins reduced cardiovascular disease mortality (relative risks 0.71-0.89), all-cause mortality (relative risks 0.66-0.93) and major cardiovascular disease events (relative risks 0.59-0.90). sodium-glucose transport protein 2 inhibitors reduced major cardiovascular disease events by 8% (relative risk 0.92, 95% confidence interval 0.89 to 0.95) and all-cause mortality by 6% (relative risk 0.94, 95% confidence interval 0.90 to 0.98). Non-pharmacological interventions showed limited evidence, though vitamin D (relative risks 0.93-0.94) and dietary changes (relative risk 0.91, 95% confidence interval 0.85 to 0.97) had some benefits. The network meta-analysis found that antihypertensives (relative risk 0.76, 95% confidence interval 0.64 to 0.90), intensive blood pressure control (relative risk 0.66, 95% confidence interval 0.46 to 0.96), statins (relative risk 0.81, 95% confidence interval 0.71 to 0.91) and multifactorial lifestyle interventions (relative risk 0.75, 95% confidence interval 0.61 to 0.92) significantly reduced composite cardiovascular disease events and mortality. Blood pressure lowering also reduced all-cause mortality (relative risk 0.82, 95% confidence interval 0.71 to 0.94). Simulation modelling projected substantial population-level health gains. National salt reduction programmes could prevent 1900-48,000 cardiovascular disease deaths annually, while tobacco control initiatives could avert 15,500 deaths yearly. In the United Kingdom, salt reduction could prevent 4450 deaths annually, and transfat elimination could prevent 1700-3500 deaths yearly. Cost-effectiveness analyses found most interventions had incremental cost-effectiveness ratio below £20,000-30,000 per quality-adjusted life-year. However, intensive diabetes treatment and enhanced motivational interviewing exceeded £55,000/quality-adjusted life-year, indicating low value for money. Limitations: Limitations included residual confounding, heterogeneity in simulation models and a lack of head-to-head trials for some interventions. More research is needed on non-pharmacological interventions, policy implementation and health economic analyses. Conclusions: This series supports antihypertensives, statins and multifactorial lifestyle interventions as core strategies for primary cardiovascular disease prevention. Policy interventions show potential for large-scale impact, and most approaches are cost-effective. Future research should prioritise head-to-head trials, implementation studies and health economic analyses to optimise prevention efforts. Funding: This synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme as award number 17/148/05.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.