CardioExchange Archive

High Blood Pressure in ICU Linked to Better Outcome: Using data from nearly 120,000 patients admitted to the ICU for chest pain, Swedish investigators found, somewhat unexpectedly, that high systolic blood pressure at the time of admission was associated with improved outcome. The association remained evident even when patients with CHF or who went on to develop CHF were removed from the analysis. The findings, the authors write in their paper in JAMA, should be used only for prognostic purposes: “Our data should not be interpreted as a suggestion not to normalize an elevated BP in patients with acute chest pain.” Nissen and JAMA Editors Weigh In on Avandia: In a commentary in JAMA, Steve Nissen provides a detailed account of events surrounding the Avandia controversy from his perspective as the author of the original meta-analysis that helped start the controversy. Nissen focuses on the deficiencies of the RECORD trial. In an accompanying editorial, JAMA editors Catherine DeAngelis and Phil Fontanarosa propose that, given the deficiencies of RECORD and other industry-sponsored trials, journals should “require that academic researchers have full access to all trial data and that all industry-sponsored trials include independent statistical analysis and assurance.”Improving Informed Consent: The high ideals of patient-centered care are compromised by the deficiencies of informed consent, according to a JAMA commentary by Harlan Krumholz (CardioExchange editor-in-chief). Krumholz proposes sweeping revisions of the current approach to informed consent, utilizing forms “standardized across institutions, with core information written by expert groups.” Krumholz provides a sample informed consent document for elective PCI.Beta-Blocker Inventor Dies: Sir James Black, the pharmacologist who won the Nobel Prize for his invention of beta-blockers, died at the age of 85. In what might be the equivalent of winning back-to-back marathons, Black followed up his earlier invention by playing a key role in the development of cimetidine, the first effective anti-ulcer drug. In 1994, Black delivered the plenary lecture at the American College of Cardiology meeting. (You can read a news report reprinted from 1994 on CardioBrief.)