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ACE inhibitors in African Americans with hypertension associated with worse outcomes as compared to other antihypertensives
Commentary on: Bangalore S, Ogedegbe G, Gyamfi J, et al.. Outcomes with angiotensin-converting enzyme inhibitors vs other antihypertensive agents in hypertensive blacks. Am J Med 2015;128:1195–203. Context Hypertension affects one-third of the world's population and remains a leading cause of myocardial infarction, stroke, heart failure, renal failure and death. Although hypertension control has improved,1 the prevalence is increasing due to an ageing population, rising obesity and a shift towards western lifestyles and disease patterns in low-income and middle-income countries. Hypertension is now also a major contr...
Source: Evidence-Based Medicine - January 22, 2016 Category: Internal Medicine Authors: Lund, L. H. Tags: EBM Prognosis, Epidemiologic studies, Drugs: cardiovascular system, Stroke, Hypertension, Obesity (nutrition), Ischaemic heart disease, Renal medicine, Drugs: musculoskeletal and joint diseases, Health education Source Type: research

Sugar-sweetened beverage consumption is linked to global adult morbidity and mortality through diabetes mellitus, cardiovascular disease and adiposity-related cancers
Commentary on: Singh GM, Micha R, Khatibzadeh S, et al., Global Burden of Diseases Nutrition and Chronic Diseases Expert Group (NutriCoDE). Estimated global, regional, and national disease burdens related to sugar-sweetened beverage consumption in 2010. Circulation 2015;132:639–66 . Context Obesity and obesity-related non-communicable diseases are global health burdens associated with all-cause and cause-specific mortality, economic costs and impaired quality of life.1–3 Sugar-sweetened beverage (SSB) consumption has been linked with obesity and has long been thought to contribute to cardiometabolic diseases th...
Source: Evidence-Based Medicine - November 24, 2015 Category: Internal Medicine Authors: Ruff, R. R. Tags: Epidemiologic studies, Drugs: cardiovascular system, Stroke, Hypertension, Diet, Obesity (nutrition), Dentistry and oral medicine, Diabetes, Health education Aetiology/Harm Source Type: research

Type 2 diabetes mellitus screening has no effect on mortality
Commentary on: Selph S, Dana T, Blazina I, et al. Screening for type 2 diabetes mellitus: a systematic review for the U.S. Preventive Services Task Force. Ann Intern Med 2015; 162:765–6. Context Screening for type 2 diabetes mellitus in asymptomatic persons could lead to early identification and treatment, and potentially result in improved outcomes. In 2008, the U.S. Preventive Services Task Force (USPSTF) recommended diabetes screening in asymptomatic adults with sustained blood pressure (BP) greater than 135/80 mm Hg. Unfortunately, the USPSTF found insufficient evidence to assess the balance of benefits...
Source: Evidence-Based Medicine - July 24, 2015 Category: Internal Medicine Authors: Yoon, U. Tags: Epidemiologic studies, Drugs: cardiovascular system, Heart failure, Stroke, Hypertension, Diet, Obesity (nutrition), Screening (epidemiology), Diabetes, Health education, Screening (public health) Therapeutics/Prevention Source Type: research

Metformin associated with better cardiovascular outcomes than other glycaemic therapies
Context A question exists as to whether the outcome of glycaemic treatment of diabetes varies with the agent used; speculation surrounds whether metformin might be preferable to other treatments. Methods Ghotbi and colleagues performed an epidemiological analysis of 8192 obese patients with diabetes at increased cardiovascular risk participating in the Sibutramine Cardiovascular OUTcomes (SCOUT) trial. Mortality and a combined cardiovascular outcome of non-fatal myocardial infarction, non-fatal stroke, resuscitation after cardiac arrest or cardiovascular death were compared among those receiving one of the following interv...
Source: Evidence-Based Medicine - May 19, 2014 Category: Internal Medicine Authors: Bloomgarden, Z. T. Tags: Smoking and tobacco, Epidemiologic studies, Drugs: cardiovascular system, Heart failure, Stroke, Hypertension, Diet, Obesity (nutrition), Ischaemic heart disease, Diabetes, Health education, Smoking Therapeutics Source Type: research

Symptoms of obstructive sleep apnoea are treated by adenotonsillectomy, but without change in neurocognitive outcome
Commentary on: Marcus CL, Moore RH, Rosen CL, et al.. A randomised trial of adenotonsillectomy for childhood sleep apnea. N Engl J Med 2013;368:2366–76. Context Adenotonsillectomy (T&A) in children is a very common surgical intervention for sleep disordered breathing and obstructive sleep apnoea (OSA). OSA in children causes cardiovascular, behavioural, developmental and cognitive sequelae. Controversies exist about many aspects of this condition including diagnosis, treatment and perioperative management. In children with severe OSA there are neurocognitive deficits and altered brain development.1 There is a bod...
Source: Evidence-Based Medicine - March 19, 2014 Category: Internal Medicine Authors: Ramsden, J. D. Tags: Clinical trials (epidemiology), Sleep disorders (neurology), Stroke, Obesity (nutrition), Child and adolescent psychiatry, Sleep disorders, Sleep disorders (respiratory medicine), Ear, nose and throat/otolaryngology, Health education Therapeutics Source Type: research

Perioperative selective serotonin reuptake inhibitor administration is a marker of poor outcomes after surgery
Commentary on: Auerbach AD, Vittinghoff E, Maselli J, et al.. Perioperative use of selective serotonin reuptake inhibitors and risks for adverse outcomes of surgery. JAMA Intern Med 2013;173:1075–81. Context With a lifetime prevalence of 6–11%, depression is a common comorbidity in surgical patients. Owing to their high efficacy and safety, selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressants.1 Some studies suggest that SSRIs may increase surgical bleeding. However, SSRI discontinuation may exacerbate psychiatric illness or precipitate withdrawal symptoms. Therefore, ...
Source: Evidence-Based Medicine - March 19, 2014 Category: Internal Medicine Authors: Holt, N. F. Tags: EBM Aetiology, Epidemiologic studies, Drugs: cardiovascular system, Drugs: CNS (not psychiatric), Heart failure, Stroke, Obesity (nutrition), Interventional cardiology, Drugs: musculoskeletal and joint diseases, Health education Source Type: research

Lower sodium intake reduces blood pressure in adults and children, but is not associated with a reduced risk of all CVD or all cause mortality
Commentary on: Aburto NJ, Ziolkovska A, Hooper L, et al.. Effect of lower sodium intake on health: systematic review and meta-analyses. BMJ 2013;346:f1326 Context More than half a century has passed since the idea that the lower blood pressure (BP) associated with lower sodium intake justifies reduced intake for all. Authoritative bodies have subsequently endorsed this view with increasingly ambitious reduction goals. The US Department of Agriculture and US Department of Health and Human Services currently recommend <1.5 g sodium/day for virtually half the population, with <2.3 g1 levels for the remainder. ...
Source: Evidence-Based Medicine - January 22, 2014 Category: Internal Medicine Authors: Alderman, M. H., Cohen, H. Tags: EBM Aetiology, Epidemiologic studies, Drugs: cardiovascular system, Drugs: CNS (not psychiatric), Stroke, Hypertension, Diet, Obesity (nutrition), Ischaemic heart disease, Health education Source Type: research

Parent-reported sleep-disordered breathing symptoms early in life predict childhood behavioural problems at age 4 and 7 years
This study focuses on prospective data collected on children involved in the large-scale, population-based Avon Longitudinal Study of Parents and Children...
Source: Evidence-Based Medicine - March 19, 2013 Category: Internal Medicine Authors: Gregory, A. M., Wiggs, L. Tags: EBM Prognosis, Epidemiologic studies, Sleep disorders (neurology), Stroke, Obesity (nutrition), Pregnancy, Sleep disorders, Sleep disorders (respiratory medicine), Screening (epidemiology), Health education, Screening (public health) Source Type: research