Role of antibiotics for the prevention of cardiovascular disease

• Published in: The Annals of pharmacotherapy Vol. 36; no. 10; pp. 1629 - 1636
• Main Authors: Gabay, MP, Jain, R
• Format: Journal Article
• Language: English
• Published: Cincinnati, OH Harvey Whitney Books 01-10-2002; SAGE Publications; Whitney
• Subjects: Anti-Bacterial Agents - pharmacology; Anti-Bacterial Agents - therapeutic use; Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Arteriosclerosis - epidemiology; Arteriosclerosis - microbiology; Arteriosclerosis - prevention & control; Biological and medical sciences; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - microbiology; Cardiovascular Diseases - prevention & control; Chlamydophila Infections - complications; Chlamydophila Infections - drug therapy; Chlamydophila pneumoniae; Clinical Trials as Topic; Humans; Medical sciences; Pharmacology. Drug treatments; Risk Factors; cardiovascular disease; Chlamydia pneumoniae; antibiotics; prophylaxis; Human; Secondary; Chlamydiaceae; Cardiovascular disease; Coronary heart disease; Infection; Vascular disease; Prevention; Antibiotic; Chemotherapy; Atherosclerosis; Primary; Chlamydiales; Bacteriosis; Bacteria; Antibacterial agent
• ISSN: 1060-0280; 1542-6270
• DOI: 10.1345/aph.1A401

OBJECTIVE:
To evaluate the data regarding the use of antibiotic therapy for the prevention of cardiovascular events.
DATA SOURCES:
Pertinent literature was identified through a MEDLINE search (1966–September 2001) and through other secondary literature databases and/or bibliographies of pertinent articles.
DATA SYNTHESIS:
Cardiovascular disease is a common cause of morbidity and mortality among the general population, with well-defined risk factors (e.g., diabetes, hypertension, hyperlipidemia, cigarette smoking, genetic predisposition). Clinical data evaluating the association between the aforementioned risk factors and the development of atherosclerosis and subsequent cardiovascular disease are substantial; however, these risk factors may only partially explain the high prevalence of cardiovascular disease. The presence of Chlamydia pneumoniae within atherosclerotic lesions has been documented and may be an additional risk factor for the development and progression of cardiovascular disease.
CONCLUSIONS:
The results of primary and secondary prevention trials have shown conflicting evidence with regard to the beneficial effects of antibiotic therapy to reduce cardiovascular events. Currently, the lack of certainty in published data does not support the use of antibiotics for the prevention of cardiovascular disease. Clinicians should continue to emphasize interventions proven to reduce adverse cardiovascular events such as smoking cessation, reduction of hyperlipidemia, and control of hypertension.