Episode 271: 270. Aprocitentan, How Well Does it Work for Resistant Hypertension?

Episode 271: 270. Aprocitentan, How Well Does it Work for Resistant Hypertension?

730 Patients were randomized to receive daily oral aprocitentan or placebo, plus a fixed-dose combination of amlodipine, valsartan, and hydrochlorothiazide.
After 4 weeks, mean change in office systolic BP was 15 mm Hg with aprocitentan and 11 mm Hg with placebo; this 4 mm difference was statistically significant.
What is the cost? What is the long term effects? Why didn't they compare this to the standard of care spironolactone?

https://www.hcplive.com/view/fda-approves-aprocitentan-tryvio-for-treatment-resistant-hypertension

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)02034-7/abstract

Episoder(387)

17. Outpatient Testing: TSH Part 1

17. Outpatient Testing: TSH Part 1

Andrew and Joe snorkel into the data on TSH testing. Breaking down the test, the patient, the benefits and risks of treatment. Just enough to get you hungry for part 2.

20 Nov 201423min

16. Outpatient Testing Part 2

16. Outpatient Testing Part 2

Andrew is back from his 21 day isolation for r/o Ebola, turns out it was just subclinical Post Testing Stress Disorder. Andrew and Joe discuss the concept of "pre" disease and common lab testing error...

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15. Clinical Testing

15. Clinical Testing

An overview of a few studies and information regarding inpatient and outpatient testing. "The first principle of solid wisdom is discretion.." --Norman MacDonald. A little discussion on understanding ...

21 Okt 201432min

14. IV Fluids part 2

14. IV Fluids part 2

Bottoms up on the last discussion on fluids and a review of a few of the trials that contribute to the current mindset in EBM. Andrew creates his own "Mike Tyson Theory of fluids" and Joe subscribes t...

3 Okt 201424min

13. IV Fluids part 1

13. IV Fluids part 1

A quick discussion one the topic of which patient to give which fluid. Review of studies from the 90s to 2014 with demographics including pre/post Operative, Septic patient and even Rattus Rattus. (th...

25 Sep 201423min

12. Dexa Scan Part 2

12. Dexa Scan Part 2

Hard topic and difficult discussion continues about reasonable intervention and evaluation of therapy for osteoporosis. Andrew starts right off with his personal recommendation on the screening of low...

10 Sep 20147min

11. The Dexa Scam

11. The Dexa Scam

Hard hitting discussion on the evidence on soft bones and the best screening and treatment options. This episode was broken into two parts because Joe needed to run a full NIH Stroke Scale on Andrew m...

1 Sep 201429min

10. Vitamin D Part 2

10. Vitamin D Part 2

Who and when to test. Dose and frequency along with route of administration of Vitamin D are discussed along with 12 studies of outcomes and complications/benefits of each. Joe discovers Andrew is bel...

13 Aug 201431min

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