March 9th, 2015
Selections from Richard Lehman’s Literature Review: March 9th
CardioExchange is pleased to reprint this selection from Dr. Richard Lehman’s weekly journal review blog at BMJ.com. Selected summaries are relevant to our audience, but we encourage members to engage with the entire blog.
JAMA Intern Med Mar 2015
Effects of Low Blood Pressure in Cognitively Impaired Elderly Patients Treated With Antihypertensive Drugs (OL): “Do carry on Rx to reduce SBP below 130 in nursing home pts @JAMAInternalMed if you want to kill them” I wrote on Twitter a couple of weeks ago. This week it will have to be “Do carry on Rx to reduce SBP below 130 in cognitively impaired elderly @JAMAInternalMed if you want to worsen their dementia.” This study was conducted over a three-and-a-half year period in two Italian memory clinics. Low daytime systolic blood pressure was independently associated with a greater progression of cognitive decline in older patients with dementia and mild cognitive impairment among those treated with blood pressure lowering medication – as most of them were.
The Lancet 7 Mar 2015 Vol 385
Effects of BP Lowering on Cardiovascular Risk According to Baseline BMI (pg. 867): I could go on at great length about elevated blood pressure and its treatments from the differing perspectives of the population and the individual. Say that (like me) you are a bit fatter than you should be and have a slightly elevated blood pressure. What does the massive database held by the Blood Pressure Lowering Treatment Trialists’ Collaboration have to say about the best drugs for you/me to take? “We found little evidence that selection of a particular class of blood pressure-lowering drug will lead to substantially different outcomes for individuals who are obese compared with those who are lean.”