Why the study?
There is no consensus on managing cardiovascular risk associated with acetylcholinesterase inhibitors in Alzheimer's disease, and clinical practices vary widely.
Intensive cardiovascular screening is not justified prior to initiating acetylcholinesterase inhibitors in Alzheimer's disease due to the rarity of serious cardiovascular adverse events.
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Removes justification for routine pre-treatment ECGs with acetylcholinesterase inhibitors; reinforces consensus on cardiovascular safety and simplifies initiation protocols.
There has been significant anxiety among prescribers regarding the potential for cardiac adverse effects associated with acetylcholinesterase (AChE) inhibitors in Alzheimer's disease. There is no consensus on how to manage this cardiovascular risk, and memory clinics vary widely in their practice. Review of published evidence reveals that the incidence of cardiovascular side-effects is low, and that serious adverse events are rare. Intensive cardiovascular screening such as pre-treatment electrocardiograms or 24 h cardiac monitoring is not justified. Furthermore, there are no high-risk groups to target. This article suggests pragmatic guidelines for managing cardiovascular risk in patients receiving AChE inhibitors. The guidelines are intended to be easy to incorporate into routine clinical practice in a memory clinic.
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Rowland et al. (2007) conducted a review in Alzheimer's disease. Acetylcholinesterase (AChE) inhibitors vs. Placebo was evaluated on Cardiovascular adverse effects. Acetylcholinesterase inhibitors are associated with a low incidence of cardiovascular side-effects, and intensive cardiovascular screening such as pre-treatment electrocardiograms is not justified.
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