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Specialty: Internal Medicine
Condition: Hypertension
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Total 432 results found since Jan 2013.
Long-term coffee consumption associated with reduced risk of total and cause-specific mortality
Commentary on: Freedman ND, Park Y, Abnet CC, Hollenbeck AR, Sinha R, et al.. Association of coffee drinking with total and cause-specific mortality. N Engl J Med 2012;366:1891–904. Context The effect of coffee consumption on health is being re-examined based on new evidence suggesting a beneficial effect of components in coffee other than caffeine,1–3 an effect that may be seen in the long term after the acute harmful effects of caffeine have disappeared. Supporting this idea, several recent well-designed cohort studies have found an inverse association between long-term coffee consumption and the risk of all-...
Source: Evidence-Based Medicine - May 15, 2013 Category: Internal Medicine Authors: Lopez-Garcia, E. Tags: EBM Aetiology, Smoking and tobacco, Epidemiologic studies, Drugs: cardiovascular system, Sleep disorders (neurology), Stroke, Hypertension, Diet, Sleep disorders, Sleep disorders (respiratory medicine), Health education, Smoking Source Type: research
Medical management of critical limb ischaemia: where do we stand today?
This article is protected by copyright. All rights reserved.
Source: Journal of Internal Medicine - June 26, 2013 Category: Internal Medicine Authors: Matthew A. Lambert, Jill J. F. Belch Tags: Review Source Type: research
N-3 fatty acids did not reduce major cardiovascular events in patients with dysglycaemia
Commentary on Bosch J, Gerstein HC, Dagenais GR, et al.. ORIGIN Trial Investigators. n-3 fatty acids and cardiovascular outcomes in patients with dysglycemia. N Engl J Med 2012;367:309–18 Context N-3 fatty acids have beneficial effects on elevated triglyceride levels, impaired endothelial function, inflammation, atherosclerotic plaque and severe arrhythmias. Prospective cohort studies have shown a lower risk of cardiovascular events among persons who consumed fish regularly. These studies were followed by clinical trials evaluating the effects of supplements with the fish fatty acids eicosapentaenoic acid (EPA) and d...
Source: Evidence-Based Medicine - July 5, 2013 Category: Internal Medicine Authors: Kromhout, D. Tags: Epidemiologic studies, Immunology (including allergy), Drugs: cardiovascular system, Stroke, Hypertension, Diet, Ischaemic heart disease, Venous thromboembolism, Drugs: musculoskeletal and joint diseases, Diabetes, Lipid disorders Prevention Source Type: research
Management of Obstructive Sleep Apnea in Adults: A Clinical Practice Guideline From the American College of Physicians.
Abstract
DESCRIPTION: The American College of Physicians (ACP) developed this guideline to present the evidence and provide clinical recommendations on the management of obstructive sleep apnea (OSA) in adults.
METHODS: This guideline is based on published literature from 1966 to September 2010 that was identified by using MEDLINE, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews. A supplemental MEDLINE search identified additional articles through October 2012. Searches were limited to English-language publications. The clinical outcomes evaluated for this g...
Source: Annals of Internal Medicine - September 24, 2013 Category: Internal Medicine Authors: Qaseem A, Holty JE, Owens DK, Dallas P, Starkey M, Shekelle P, for the Clinical Guidelines Committee of the American College of Physicians Tags: Ann Intern Med Source Type: research
Screening, Monitoring, and Treatment of Stage 1 to 3 Chronic Kidney Disease: A Clinical Practice Guideline From the Clinical Guidelines Committee of the American College of Physicians.
Abstract
DESCRIPTION: The American College of Physicians (ACP) developed this guideline to present the evidence and provide clinical recommendations on the screening, monitoring, and treatment of adults with stage 1 to 3 chronic kidney disease.
METHODS: This guideline is based on a systematic evidence review evaluating the published literature on this topic from 1985 through November 2011 that was identified by using MEDLINE and the Cochrane Database of Systematic Reviews. Searches were limited to English-language publications. The clinical outcomes evaluated for this guideline included all-cause mortality, c...
Source: Annals of Internal Medicine - October 22, 2013 Category: Internal Medicine Authors: Qaseem A, Hopkins RH, Sweet DE, Starkey M, Shekelle P Tags: Ann Intern Med Source Type: research
Ceruloplasmin dysfunction: a key factor in the pathophysiology of atrial fibrillation?
This article is protected by copyright. All rights reserved.
Source: Journal of Internal Medicine - November 5, 2013 Category: Internal Medicine Authors: Jamie Y Jeremy, Nilima Shukla Tags: Editorial Comment Source Type: research
Meta-analysis shows limited benefit of lowering blood pressure below 130/80 mm Hg in patients with type 2 diabetes
Commentary on: McBrien K, Rabi DM, Campbell N, et al.. Intensive and standard blood pressure targets in patients with type 2 diabetes mellitus: systematic review and meta-analysis. Arch Intern Med 2012;172:1296–303. Context Although lowering blood pressure (BP) to the standard target of 140/90 mm Hg improves cardiovascular outcomes in patients with type 2 diabetes mellitus (T2DM), the benefits of more intensive lowering to <130/80 mm Hg have not been conclusively demonstrated. Despite this shortcoming, most current practice guidelines recommend this lower target. Two meta-analyses of studies ev...
Source: Evidence-Based Medicine - November 21, 2013 Category: Internal Medicine Authors: Koraishy, F. M., Peixoto, A. J. Tags: Epidemiologic studies, Genetics, Drugs: cardiovascular system, Stroke, Hypertension, Ischaemic heart disease, Diabetes Therapeutics Source Type: research
Long-term aspirin use and neovascular age-related macular degeneration: association or causation?
Commentary on: Liew G, Mitchell P, Wong TY, et al.. The association of aspirin use with age-related macular degeneration. JAMA Intern Med 2013;173:258–64. Context Aspirin is used by many for temporary pain relief, rheumatological conditions and where indicated, cardioprotection. However, recent findings from observational studies have raised the possibility that regular aspirin use may also increase the risk of some forms of age-related macular degeneration (AMD). Methods Liew and colleagues examined the relationship between long-term, low-dose aspirin use and risk of AMD in an Australian population-based cohort of 2...
Source: Evidence-Based Medicine - January 22, 2014 Category: Internal Medicine Authors: Christen, W. G. Tags: EBM Aetiology, Smoking and tobacco, Epidemiologic studies, Immunology (including allergy), Drugs: cardiovascular system, Pain (neurology), Stroke, Hypertension, Ophthalmology, Pain (palliative care), Pain (anaesthesia), Diabetes, Health education, Smoking Source Type: research
Ramipril improves walking times and quality of life in patients with stable intermittent claudication
Commentary on: Ahimastos AA, Walker PJ, Askew C, et al.. Effect of ramipril on walking times and quality of life among patients with peripheral artery disease and intermittent claudication: a randomized controlled trial. JAMA 2013;309:453–60. Context Intermittent claudication (IC) is a common condition that may be associated with significant disability and reduction in quality of life. Pharmacological options for the treatment of the symptoms of this condition are very limited. Naftidrofuryl oxalate is recommended in the National Institute for Health and Care Excellence (NICE) guidelines,1 and while this has been sho...
Source: Evidence-Based Medicine - January 22, 2014 Category: Internal Medicine Authors: Brittenden, J. Tags: Health policy, Clinical trials (epidemiology), Epidemiologic studies, Drugs: cardiovascular system, Stroke, Hypertension, Health service research Therapeutics Source Type: research
Limited impact of omega-3 fatty acids in patients with multiple cardiovascular risk factors
Commentary on: Roncaglioni MC, Tombesi M, et al.. Risk and Prevention Study Collaborative Group. n-3 fatty acids in patients with multiple cardiovascular risk factors. N Engl J Med 2013;368:1800–8 Context Ecological, case–control and prospective studies consistently demonstrate reduced cardiovascular morbidity and mortality associated with higher intake of fish and their constituent omega-3 fatty acids and with higher omega-3 fatty acid status.1 This effect has been ascribed to improvement of the cardiovascular risk profile resulting in disease prevention.1 Trials in patients following myocardial infarction (MI...
Source: Evidence-Based Medicine - January 22, 2014 Category: Internal Medicine Authors: Calder, P. Tags: Clinical trials (epidemiology), Epidemiologic studies, General practice / family medicine, Immunology (including allergy), Drugs: cardiovascular system, Stroke, Hypertension, Ischaemic heart disease, Arrhythmias Therapeutics Source Type: research
Dietary salt reduction; further lowering of target lowers blood pressure but may increase risk
Commentary on: He FJ, Li J, Macgregor GA. Effect of longer-term modest salt reduction on blood pressure. Cochrane Database Syst Rev 2013;(4):CD004937. Context Numerous studies have shown that a high dietary salt intake increases blood pressure (BP) and the risk of cardiovascular events.1 2 Conversely, a moderate and even low-level salt intake lowers BP in a dose-dependent way. Methods He and colleagues have performed a thorough and comprehensive meta-analysis of 34 randomised controlled trials (RCTs) assessing the impact of modest reduction in salt intake with a trial duration of at least 4 weeks. Findings The present...
Source: Evidence-Based Medicine - January 22, 2014 Category: Internal Medicine Authors: Messerli, F. H., Bangalore, S. Tags: Clinical trials (epidemiology), Drugs: cardiovascular system, Drugs: CNS (not psychiatric), Heart failure, Stroke, Hypertension, Diet, Ischaemic heart disease Therapeutics Source Type: research
Perioperative {beta}-blockade improves outcomes in higher risk patients following non-cardiac surgery
Commentary on: London MJ, Hur K, Schwartz GG, et al.. Association of perioperative β-blockade with mortality and cardiovascular morbidity following major noncardiac surgery. JAMA 2013;309:1704–13. Context There has been recent controversy in the perioperative community amid allegations of scientific misconduct and there remains uncertainty about the effectiveness and safety of perioperative β-blockade in patients undergoing non-cardiac surgery.1 Current American Heart Association/American College of Cardiology Foundation (AHA/ACCF) Guidelines on perioperative evaluation and care for non-cardiac surgery limi...
Source: Evidence-Based Medicine - January 22, 2014 Category: Internal Medicine Authors: Vaishnava, P., Eagle, K. A. Tags: EBM Aetiology, Epidemiologic studies, Drugs: cardiovascular system, Stroke, Hypertension, Interventional cardiology, Ischaemic heart disease, Ethics 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
Is age‐related macular degeneration a manifestation of systemic disease? New prospects for early intervention and treatment
This article is protected by copyright. All rights reserved.
Source: Journal of Internal Medicine - February 1, 2014 Category: Internal Medicine Authors: Gemmy Chui Ming Cheung, Wong Tien Yin Tags: Review Source Type: research
Suggestions for improving guideline utility and trustworthiness
Several underemphasised limitations of guidelines need proactive remediation in meeting the contemporary needs of clinicians Clinical practice guideline (CPG) panels are expected to abide by standards that ensure their processes are multidisciplinary, systematic and unbiased.1 Unfortunately, many CPGs fail to satisfy these standards. Only a third of 130 US guidelines produced by subspecialty societies between 2006 and 2011,2 satisfied more than 50% of standards set by the Institute of Medicine (IOM—see table 1),1 relating to panel composition, conflicts of interest, evidence synthesis, reconciliation of different int...
Source: Evidence-Based Medicine - March 19, 2014 Category: Internal Medicine Authors: Scott, I. A., Guyatt, G. H. Tags: Medical education, Editor's choice, Drugs: cardiovascular system, Stroke, Hypertension, Screening (oncology), Ischaemic heart disease, Prostate, Screening (epidemiology), Ethics, Legal and forensic medicine, Medical humanities, Guidelines, Screening (publ Source Type: research
