In episode 208, James and Mike PREMIUM to the max with three interesting studies that could change your practice. We talk about duration of steroids for COPD exacerbations, when to start allopurinol after a gout attack and which NSAIDs are the safest from a cardiovascular perspective. You need to hear all about this!

Show notes

 1) Starting allopurinol right after an acute attack of gout

Amer J Med 2012;125:1126-34

2) COPD steroid treatment for acute exacerbations – 5 days or 14 days

JAMA 2013;309(21):doi:10.1001/jama.2013.5023

3) NSAIDs and cardiovascular risk

PLOS Med 2013;2:1-6

In episode 207, Mike and James keep up the pressure on blood pressure measurements. We talk about the magnitude of the benefit, the variability of all these measurements and get into the whole starting and stopping approach. At the end of the podcast we decide the bottom line is to not panic, sit back, put up your feet and relax and try to get your patients to do the same thing.

Show notes

1) NICE – Clinical management of primary hypertension
in adults

2) Blood pressure variability

Hypertension 2010;56:533-9

Am J Hyper 2008;21:3–4

Br J Gen Pract 2010;60:675–80

BMJ 2009;338:b1492

In episode 206, James and Mike start to tackle the holy gospel of blood pressure measurements and interestingly feel under pressure the entire way due to the trickiness of the evidence. We discuss office measurements, automated measurements, home measurements, 24-ambulatory measurements and at the end realize we have likely raised the blood pressure of our listeners but on principle we refuse to measure it.

 Show notes

1) Screening

Canadian Task Force on Preventive Health Care and the Canadian
Hypertension Education Program

2) Automated blood pressures

BMJ 2011;342:bmj.d286 

3) MAPEC study

Chronobiol Int 2010;27:1629-51

4) Waste and Harm in the Treatment of Mild
Hypertension     

JAMA Intern Med. 2013;():1-2. doi:10.1001/jamainternmed.2013.970.
doi:10:1001/jama.2010.920

5) Mild hypertension – effect of propranolol in mild hypertension

Lancet 1966;2:1148–50