Episode 402: 410. When You Shouldn't Double Down But Instead Hit for Another

Episode 402: 410. When You Shouldn't Double Down But Instead Hit for Another

This massive meta-analysis of 484 randomized, double-blind, placebo-controlled trials (104,176 participants) quantified the blood pressure–lowering effects of major antihypertensive drug classes and their combinations. It introduces a new intensity-based classification system and an online calculator to predict BP-lowering efficacy based on drug, dose, and baseline BP.



Study Design:

  • 484 trials, 104,176 participants
  • 5 major drug classes: ACE inhibitors, ARBs, β-blockers, calcium channel blockers (CCBs), and diuretics
  • Focus: Placebo-corrected reduction in systolic BP (SBP)
  • Mean baseline BP: 154/100 mm Hg
  • Mean follow-up: 8.6 weeks


Key Findings

Monotherapy (Standard Dose):

  • Average SBP reduction: 8.7 mm Hg
  • By class:
    • ACE inhibitors: 6.8 mm Hg
    • ARBs: 8.5 mm Hg
    • β-blockers: 8.9 mm Hg
    • CCBs: 9.5 mm Hg
    • Thiazide diuretics: 10.8 mm Hg

Dose Doubling:

  • Adds ~1.5 mm Hg SBP reduction (except β-blockers, which add only ~0.5 mm Hg)

Dual Therapy (Standard Dose of Each):

  • Average SBP reduction: 14.9 mm Hg
  • Dose doubling adds ~2.5 mm Hg more

Triple Therapy:

  • SBP reduction: Up to 22.5 mm Hg (quadruple therapy even higher in one trial)

Jaksot(385)

Episode 415: 422. Finerenone restores fertility?

Episode 415: 422. Finerenone restores fertility?

Lin Z, et al. Antifibrotic drug finerenone restores fertility in premature ovarian insufficiency. Science 2026 Feb 5; 391:eadz4075. DOI: 10.1126/science.adz4075. Premature ovarian insufficiency is usu...

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Episode 414: 421. Scabies and DUKE criteria

Episode 414: 421. Scabies and DUKE criteria

Stavropoulou E, et al. Reassessing the 2023 International Society for Cardiovascular Infectious Diseases Duke clinical criteria for infective endocarditis: Impact of excluding fever and updating diagn...

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Episode 413: 420. Frail and CODE LVO PLUS antibiotics don't help viral illness

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we look at CODE LVO and what does being frail even mean?????vaccines may not help baby and antibiotics still don't help viral illness

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Episode 412: CME song --Check the Lytes

Episode 412: CME song --Check the Lytes

CME song --Check the Lytes

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Episode 411: CME - sodium, potassium, calcium

Episode 411: CME - sodium, potassium, calcium

CME - sodium, potassium, calcium

20 Tammi 43min

Episode 410: 418.  Beta Blockers Post MI, PSA, Youtube,

Episode 410: 418. Beta Blockers Post MI, PSA, Youtube,

10.1016/j.jaip.2025.07.005.40675327All of the videos were found to be useful or very useful, 99% were of moderate or high reliability, and 99% had moderate to excellent educational quality  Prostate-s...

15 Joulu 202540min

Episode 409: 417. Aspirin, Pre-diabetes, Menopause, Type 1 Diabetes, HPV Vaccine and more!!!!

Episode 409: 417. Aspirin, Pre-diabetes, Menopause, Type 1 Diabetes, HPV Vaccine and more!!!!

Wolfe R, Broder JC, Zhou Z, et al. Aspirin, cardiovascular events, and major bleeding in older adults: extended follow-up of the ASPREE trial. Eur Heart J. 12 Aug 2025. [Epub ahead of print]. https://...

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Episode 408: 416. Car Seats, Beta-Blockers after a Heart Attack, Oral Semaglutide, High-Dose influenza vaccine

Episode 408: 416. Car Seats, Beta-Blockers after a Heart Attack, Oral Semaglutide, High-Dose influenza vaccine

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17 Marras 202522min

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