Questioning Medicine16 Okt 2025

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)

Det här avsnittet är hämtat från ett öppet RSS-flöde och publiceras inte av Podme. Det kan innehålla reklam.

Avsnitt(397)

Episode 435: 442. 7 article review

we unpack whether rivaroxaban followed by aspirin improves thromboprophylaxis after hip and knee arthroplasty, put oral GLP-1 therapy orforglipron head-to-head with dapagliflozin for type 2 diabetes, ...

10 Sep 33min

Episode 434: 441. Coronary Artery Calcium (CAC) -- Yacky Yack, the details on CAC

Does a Coronary Artery Calcium (CAC) scan still earn its place in modern cardiovascular prevention? This podcast cuts through the headlines to examine the recent research, challenge overconfident conc...

31 Aug 48min

Episode 433: 440. CME Understanding Medical Stats

OMED lecture on how to understand medical stats

21 Aug 33min

Episode 432: 439. 6 articles in 2026

CME

24 Juli 25min

Episode 431: 438. CME- What To Do AFTER PE Diagnosis

OMED lecture

21 Juli 26min

Episode 430: edit fix 437. A Brief Review of the Medical Literature!

Xin X, et al. Optimal exercise modalities and dosages for blood pressure reduction in adults with prehypertension and established hypertension: A network meta-analysis and dose–response relationship s...

8 Juli 32min

Episode 429: 436. postpartum burnout., asundexian, semaglutide and ETOH, neck infection, varenicline

Jafari K, et al. Risk factors for pediatric deep neck infection revisit after emergency department discharge for pharyngitis or localized neck symptoms. Ann Emerg Med 2026 May; 87:605. DOI: 10.1016/j....

15 Juni 31min

Episode 428: 435. Evolocumab, Statin and CKD, PCN allergy, MRI vs Rotator Cuff

https://pubmed.ncbi.nlm.nih.gov/41903215/ Evolocumab to Reduce First Major Cardiovascular Events in Patients Without Known Significant Atherosclerosis and With Diabetes: Results From the VESALIUS-CV ...

8 Maj 17min