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This analysis finds no strong evidence that age should determine the choice of drug rather than tolerability or cost. The accompanying editorial says that the absolute benefit of blood pressure lowering increases with age and management of overall cardiovascular risk.
When blood pressure is measured in the first or second trimester of pregnancy, mean arterial pressure is the best predictor of pre-eclampsia. The accompanying editorial says that while mean arterial blood pressure is a better predictor than diastolic or systolic pressures in women at low risk, it is still only moderately effective.
Knowing daily patterns of use can help to explain poor blood pressure control: here almost half of patients took at least one drug holiday a year, and poor daily adherence predicted early stopping of treatment.
Survival at 24 and 25 weeks' gestation in the UK Trent region significantly increased, but there was no improvement in survival at 23 weeks and no infants born at 22 weeks survived despite advances in care. The accompanying editorial says that viability is not determined solely by gestational age.
A significant rise in the prevalence of isoniazid resistance from 5% to 7% probably reflects the rise in drug resistant cases in people from sub-Saharan Africa and the Indian subcontinent and inadequate control of transmission in London. The accompanying editorial says that control depends on a global perspective, not solely on local strategies.
In 901 people at NHS stop smoking service clinics adding nortriptyline to nicotine replacement therapy made no significant difference to quit rates, withdrawal symptoms, or urge to smoke but did reduce anxiety and depression initially. An accompanying editorial agrees that current evidence does not support routine use of combination therapy with nortriptyline.
Self monitoring - whether intensive or not - is unlikely to be cost effective if added to standardised usual care, and initially reduces quality of life. Self monitoring also had no effect over one year on HbA1c, body mass index, use of oral hypoglycaemic drugs, or reported hypoglycaemia but was associated with a 6% higher score for depression.
What can you learn from this BMJ paper? Read Leanne Tite's Paper+