Cardiovascular diseases (CVDs) continue to be a significant global health concern, causing millions of deaths each year. However, there has been substantial progress in the field of evidence-based medicine in the prevention and treatment of cardiovascular diseases, leading to a noticeable decrease in cardiovascular mortality rates.

One of the key advancements in recent decades has been the development of more accurate risk prediction models, allowing healthcare providers to better identify individuals at high risk of cardiovascular events. Additionally, advancements in biomarker testing, such as high-sensitivity troponin assays and B-type natriuretic peptide (BNP) testing, have improved risk stratification and early detection of patients at elevated risk of adverse cardiovascular events.

Since the release of pivotal trial results in the 1990s, statins have become a cornerstone in managing dyslipidemia, demonstrating potent lipid-lowering effects and other beneficial effects like stabilizing atherosclerotic plaques and reducing inflammation. Recent trials on PCSK9 inhibitors have also shown promising results in lowering low-density lipoprotein cholesterol and reducing cardiovascular events.

Clinical trials on medications like angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, aldosterone antagonists, and angiotensin receptor blockers (ARBs) have significantly contributed to the management of hypertension, heart failure, and post-myocardial infarction care, ultimately leading to a decrease in cardiovascular mortality rates. Renin-active agents have shown benefits in various patient populations, including those with heart failure, established vascular disease, and diabetes.

Furthermore, the introduction of novel antithrombotic agents like direct oral anticoagulants (DOACs) has revolutionized the management of atrial fibrillation, reducing the risk of stroke and systemic embolism. Regulatory requirements, such as the mandate by the US Food and Drug Administration in 2008 to demonstrate cardiovascular safety for new diabetes medications, have also played a crucial role in shaping the landscape of cardiovascular disease management.

Overall, evidence-based medicine has significantly contributed to the progress made in reducing cardiovascular mortality rates over the past few decades. With ongoing research and advancements in medical treatment modalities, the future holds promise for further improvements in cardiovascular health outcomes.