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)

Episoder(385)

Episode 423: 430. Hormone Replacement Therapy and the Black Box Warning

Episode 423: 430. Hormone Replacement Therapy and the Black Box Warning

Let’s rewind to the early 2000s. Flip phones were cool, low-rise jeans were a crime, and the Women’s Health Initiative—WHI—dropped what became the medical equivalent of a headline: “Hormone Therapy In...

24 Mar 12min

Episode 422: 429. Rivaroxaban vs Apixaban = The Battle of the Blood Thinners!

Episode 422: 429. Rivaroxaban vs Apixaban = The Battle of the Blood Thinners!

— rivaroxaban versus apixaban.Yes, folks, this is The Battle of the Blood Thinners!And spoiler alert — one of them came out looking like the overachiever in a safety class... while the other probably ...

20 Mar 9min

Episode 421: 428. Asthma and Stroke --- A breathless combination

Episode 421: 428. Asthma and Stroke --- A breathless combination

Minocycline in Acute Ischemic Stroke (EMPHASIS trial)A multicenter, double-blind RCT in China studied 1,724 patients with acute ischemic stroke treated within 72 hours of onset. Patients received eith...

13 Mar 16min

Episode 420: 427. Kawasaki disease-no, not the motorcycle company

Episode 420: 427. Kawasaki disease-no, not the motorcycle company

Today, we're talking about Kawasaki disease-no, not the motorcycle company, though sometimes treating it does feel like trying to ride one at full speed through uncertainty.For decades, high-dose aspi...

11 Mar 7min

Episode 419: 426. Go Big or Go Partial? The Knee Replacement Showdown

Episode 419: 426. Go Big or Go Partial? The Knee Replacement Showdown

Setting the stagePicture this: your knee is like a three-room apartment. You've got a medial room, a lateral room, and a patellofemoral room. In isolated anteromedial osteoarthritis, just one room is ...

10 Mar 11min

Episode 418: 425. Triptan initiation and cerebrovascular events

Episode 418: 425. Triptan initiation and cerebrovascular events

Kalapura C, et al. Triptan initiation and cerebrovascular events in patients with migraine: A nationwide cohort study. J Am Heart Assoc 2026 Feb 17; 15:e043409. DOI: 10.1161/JAHA.125.043409.  Today, w...

6 Mar 6min

Episode 417: 424. GLP1 and NAION

Episode 417: 424. GLP1 and NAION

Li H-Y, et al. GLP-1 receptor agonists and risk of optic nerve or vision-threatening events in patients with type 2 diabetes or cardiometabolic diseases: A meta-analysis of randomized controlled trial...

5 Mar 8min

Episode 416: 423. CME-- Discharge Questions Answered in 2025

Episode 416: 423. CME-- Discharge Questions Answered in 2025

CME-- Discharge Questions Answered in 2025

3 Mar 45min

Populært innen Helse

fastlegen
lydartikler-fra-aftenposten
rss-gukild-johaug
hvordan-har-du-det-mann
psykodrama
leger-om-livet
rss-garne-damer
relasjonspodden-med-dora-thorhallsdottir-kjersti-idem
foreldreradet
rss-lopedrommen
morten-ramm-lar-kakla-ga-til-du-sovner
bak-fasaden-en-reise-i-livet-med-sykepleier-ine
klimaks
hjernesterk
rss-lev-vel
sinnsyn
hormonelle-frida
rss-kunsten-a-leve
g-punktet
helsetipspodden