Commentary

Apr 26, 2011

Nearly two-thirds of all Americans diagnosed with high blood pressure are treated with medications - but fewer than half are controlled to their goal. And the rate of control is even lower in racial and ethnic minority subgroups.1,2  Patients who are younger, non-white, as well as those with asymptomatic chronic diseases and taking multiple daily medications have lower medication...

Comments: 1      Views: 6,452


Mar 16, 2011

Are all of your patients with symptomatic heart failure and a low ejection fraction receiving an aldosterone antagonist?  Why not?  Randomized, double-blind, multi-center clinical trials using aldosterone-receptor antagonists have demonstrated mortality benefits in patients with symptomatic heart failure when added to evidence-based therapy, including ACE-inhibitors.1,2,3  The recent...

Comments: 5      Views: 13,877


Feb 27, 2011

One in 3 adults in the United States have high blood pressure (HBP).1 That’s more than 74 million people!  From 1996 to 2006 the death rate due to HBP increased 19.5%. In those with hypertension, blood pressure (BP) control is poor.  In men, less than 40% are achieving their blood pressure goal.  In women, the percentage who are control is even worse.  In women age 60-79 years old only 28% are at their target BP and in women over 80 years old only 23% are at goal.2 Achieving a target BP is...

Comments: 2      Views: 11,931


Jan 13, 2011

Step one, short-acting beta agonists (SABA) as needed.  Step two: low dose inhaled corticosteroids (ICS). Step three, increase to medium dose ICS or add a long-acting beta agonist (LABA).  These are the preferred steps that are recommended by current asthma guidelines.1  But is there a better option for step three?  A recent double-blind, three-way, crossover trial set out to answer...

Comments: 0      Views: 4,509


Dec 7, 2010

If you are like me, you probably received a lot of phone calls from patients and prescribers when the news hit about the potential interaction between clopidogrel and proton pump inhibitors (PPIs).  In January 2009, the Food and Drug Administration (FDA) published data from an ongoing safety review of clopidogrel effectiveness, which resulted in a November 2009 Public Health Advisory that recommended avoiding of the combination of clopidogrel and any PPIs...

Comments: 3      Views: 11,629


Nov 4, 2010

Clinicians and patients alike have been anxiously waiting for an oral alternative to warfarin. That wait appears to be finally over. On October 19, 2010 dabigatran (Pradaxa®) was approved by the FDA and became the first oral direct thrombin inhibitor available in the United States. Unlike its predecessor ximelagatran, dabigatran doesn’t seem to cause liver toxicity. And unlike warfarin, dabigatran is administered as a fixed dose and requires no ongoing...

Comments: 8      Views: 24,482


Oct 18, 2010

Non-alcoholic fatty liver disease (NAFLD) is a condition characterized by fat deposition in the hepatocytes of patients with minimal or no alcohol intake.  NAFLD has emerged as the leading cause of chronic liver disease in the Western world, with an estimated prevalence of 20-30% in the general population.1  Patients with NAFLD may present along spectrum of histological findings, ranging from simple hepatic steatosis (fat accumulation without inflammation or fibrosis) to nonalcoholic...

Comments: 0      Views: 4,823


Mar 30, 2010

UPDATE:  See related story regarding editorial and open letter to NCEP ATP IV

I’ve long believed that statin therapy should be guided by a clinical risk assessment – not LDL cholesterol goals. None of the landmark clinical trials demonstrating the benefits of statin therapy have titrated the dose to an LDL goal. None. Participants were eligible for the studies based on clinical...

Comments: 2      Views: 11,162


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