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Therapeutics Education Collaboration
Medication Mythbusters – Home of the Best Science (BS) Medicine Podcast

Video References



ACCORD – glucose lowering

NEJM 208;358:2545-59

ACCORD – blood pressure lowering

NEJM 2010:10.1056/NEJMoa1001286

Effect of intensive control of glucose on cardiovascular outcomes – meta-analysis

Lancet 2009;373:1765–72


N Engl J Med 2008 358:2560-2572

VADT trial

N Engl J Med 2009;360:129-39

Glucose lowering meta-analysis – do the results support the conclusions?

Lancet 2009; 373:1765-72

UKPDS data

BMJ 2000;320:1720-3

UKPDS (original trial)

Lancet 1998;352:854-65

UKPDS (recent results)

NEJM 2008;359:1577-89


N Engl J Med 2008;358:580-91


Lifetime risk of dialysis and blindness

Ann Intern Med 1997;127:788-95

Estimated benefits of glycemic control in microvascular complications in type 2 diabetes

Ann Intern Med 1997;127:788-95

Risk of dialysis in type 2 diabetes

Diabetes Care 2003;26:2353-8


Impact of glycosylated hemoglobin on functional decline

J Am Geriatr Soc 2012;60:1215–21


Metformin meta-analysis  – is it good or bad?

PLoS Med 9(4): e1001204. doi:10.1371/journal.pmed.1001204


Diabetes Care 2012 Dec 10 (Epub ahead of print)

UKPDS 34 metformin 

Lancet 1998;352:854-65


Diabet Med 2013;30:1160–71


N Engl J Med 2012; 367:319-328


SAVOR-TIMI 53 – saxagliptin and cardiovascular outcomes

September 2, 2013DOI: 10.1056/NEJMoa1307684 

EXAMINE – alogliptin and cardiovascular outcomes

September 2, 2013DOI: 10.1056/NEJMoa1305889

Sulphonylureas and risk of cardiovascular disease:systematic review and meta-analysis

Diabet Med 2013;30:1160–71



N Engl J Med 2007;356:2457-71

ACP Journal Club 2007Nov-Dec;147:66

Arch Intern Med 2010;170(14):1191-1201

Food and Drug Administration. Briefing document:July13-14,2010 meeting of the

Endocrinologic and Metabolic Drugs Advisory Committee

JAMA 2010;304:411-418

BMJ 2010;340:c1344.doi:10.1136/bmj.c1344

Diabetes Care 2009;32:193-203

Glitazones meta-analyses

JAMA 2007;298:1180-8

JAMA 2007;298:1189-95


Association of an Intensive Lifestyle Intervention With Remission of Type-2 Diabetes – LookAHEAD

JAMA 2012;308:2489-96. doi:10.1001/jama.2012.67929

Self-monitoring of blood glucose 


BMJ 2008;336:1174-7


BMJ 2008;336:1177-80

BMJ 2007;335:132

BMJ 2007;335:105-6


Ann Int Med 2009;150:803-8

ASA – no benefit in diabetics

JAMA 2008;300:2134-41

BMJ 2008;337:a1840

ASA -general

Arch Intern Med 2012;172:209-16




Statin meta-analyses

Lancet 2008;371:117-25

Relative risk reduction with statins in primary prevention

BMJ 2009;338:b2376

ACP J Club 2009;151:14

Lancet 2005;366:1267–78

Diabetes – Lancet 2008;371:117–25

Statin intolerance

RxFiles – Statin intolerance – management considerations

Statins and the elderly

J Am Coll Cardiol 2013;doi:10.1016/j.jacc.2013.07.069

High dose vs low dose

How does high dose statin compare to low dose in people with heart disease?

SEARCH – low dose (20 mg) vs high dose (80 mg) simvastatin in patients after an MI

Lancet 2010;376:1658-69

Statin dose meta-analysis response 

CMAJ 2008;178:576-84

Statins in women

J Am Coll Cardiol 2012;59:572–82 

Circulation 2010;121:1069-77





N Engl J Med 2011;365:2255-67

Combined analysis

Am J Cardiol 2013;111:352-5

Niacin Coronary drug project 

Eur J Clin Pharmacol 1991;40 [Suppl 1]: S49-S51


ACCORD – fenofibrate

NEJM 2010:10.1056/NEJMoa1001282

FIELD – fenofibrate

Lancet 2005;366:1849-61

Studies, systematic reviews and meta-analyses of fibrates

Am Heart J 2007;154:943-53

Am J Med 2009; 122: 962.e1-962.e8

J Am Coll Cardiol 2005;45:185–97

Arch Intern Med. 2005;165:725-730

Int J Cardiol 2009; doi:10.1016/j.ijcard.2008.11.211

Helsinki Heart Study

NEJM 1987;317:1237-45



N Engl J Med 2008;358:1431-43 


N Engl J Med 2008;359:1343-56 

Cancer data 

N Engl J Med 2008;359:1357-66

Ezetimibe vs niacin – niacin better? 


N Engl J Med 2009;361:2113-22

N Engl J Med 2008;358:1819-28



N Engl J Med 2012 DOI: 10.1056/NEJMoa1206797


N Engl J Med 2007;357:2109-22

 Lipid Research Clinics Trial

JAMA 1984;251:351-64

High cholesterol in patients over age 75-80

Ann Epidemiol 2004;14:705–21

JAMA 1994;272:1335-40

Ann Int Med 1997;126:753-60

J Am Geriatr Soc 2004;52:1639-47

Arch Int Med 2003;163:1549-54

J Am Geriatr Soc 2005;53:2159-64

J Am Geriatr Soc 2005;53:219-26





BMJ 2009;338:b1665

Targets for hypertension


Mild hypertension



J Htn 1993;11(suppl4):S61-73, 

Lancet 2004;364:1684–9, 

Ann Intern Med 2003;138:587-92

Benefit regardless of level

BMJ 2009;338:b1665doi:10.1136/bmj.b1665.

Specific drugs


N Engl J Med 2012.DOI: 10.1056/NEJMoa1208799 


Lancet 2004;364:1684–9



N Engl J Med 2008;358:1887-98

Tools for practice

Can Fam Phys 2010;56:1141

Hypertens Res 2008;31:1595-601

Hypertension 2010;56:196-202

Different numbers

150 SBP vs 140 SBP

Hypertension 2010;56:196-202

Systematic review of intensive BP treatment

Cochrane review CD004349

Specific studies

ACCORD blood pressure study

N Engl J Med 2010;362:1575-8


Lancet 2009;374:525–33

AASK – chronic kidney disease

N Engl J Med 2010;363:918-29

INVEST – retrospective data

JAMA 2010;304:61-68


BMJ 1998;317:703-13

HOT Trial

Waste and Harm in the Treatment of Mild Hypertension     

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



N Engl J Med 2013 DOI:10.1056/NEJMoa1200303

Lancet 1994;343:1454-59

Ann Intern Med 2009;151:306-14

Lancet 2002;360:1455–61

BMJ 2008;337:a1344

Meta-Analysis Comparing Mediterranean to Low-Fat Diets for Modification of Cardiovascular Risk Factors

Amer J Med 2011;124:841-51


A & E harmful

Can Fam Physician 2005;51:1471-2


Tools for practice

Multivitamins unnecessary

JAMA 2010;304:1592-1601

Vitamin B increases mortality

BMJ 2010;341:c6273

Increased mortality for beta-carotene, Vitamin A, Vitamin E, but not for selenium and Vitamin C

JAMA 2007;297:842-57

Cochrane Database Syst Rev 2008;(2):CD007176

Vitamin B (folic acid) and homocysteine – 1 positive trial, 3 negative trials

JAMA 2002; 288:973-9

N Engl J Med 2004;350:2673-81

JAMA 2004;291:565-75

J Am Coll Cardiol 2003;41:2105-13

Diet type

Tools for Practice

Is any diet better for weight loss or preventing negative health outcomes?

Low glycaemic index or low glycaemic load diets for overweight and obesity 

Cochrane Library

Low fat, low carb vs Mediterranean

N Engl J Med 2008;359:229-41

4 different diets (varying concentrations of carbohydrate, protein and fat)

N Engl J Med 2009;360:859-73

Cohort data – increased mortality with low carb diets especially if protein and fat from animal sources

Eur J Clin Nutr 2007;61:575-81

Ann Intern Med 2010;153:289-98

Very low calorie diets

Obesity 2006;14:1283-93

Obesity 2008;16:2456–61

Little evidence for any one commercial diet over another

Ann Intern Med 2005;142:56-66

Am J Med 2005;118:991-7

Obesity 2007;15:421-9

JAMA 2004;292:2482-90

Int J Obes 2004;28:1349-52 

No difference if you eat fat or protein or carbs

Int J Obes 2006;30:552-60

Arch Intern Med 2006;166:1466-75

Am J Clin Nutr 2005;81:1298-306

Arch Intern Med 2004;164:210-7

J Int Med 2007;261:366-74

Am J Clin Nutr 2006;84:813-21

JAMA 2003; 289:1837-50

Cochrane 2002;2:CD003640

JAMA 2007;297:969-77

Int J Obes 2004;28:1283-90

Ann Intern Med 2004;140:778-85

N Engl J Med 2008;359:229-41

Fish oil

Arch Intern Med 2005;165:725-30

Can Fam Phys 2006;52:734-40

BMJ 2006;332:752-760

Omega-3 fatty acids

N Engl J Med 2013;368:1800-8



Quality of life

Arch Intern Med 2009;169:269-278

Exercise Improves: Sleep, osteoarthritis pain, depression, obesity, glucose, lipids, BP

Cochrane 2002;CD003404

J Gerontol A Biol Sci Med Sci 2008;63:997-1004

J Sports Med Phys Fitness 2007;47:462-7

Cochrane 2008:CD004366

Cochrane 2008:CD004376

Inactivity a bigger risk than weight

J Am Geriatr Soc 2010;58:234–241

More activity, better

Br J Sports Med 2008;42:238–243

NEJM 1999;341:650-8

Eur J Epidemiol 2009;24:181–192

Activity vs angioplasty

Circulation 2004;109:1371-8

Morbidity and mortality

Arch Intern Med 2007;167:2453-60

JAMA 1995; 273:1093-8

Circulation 2008;117:614-22

JAMA 2003;289:2379-86

NEJM 2002;347:716-25

Arch Intern Med 2007;167:2453-60

JAMA 2003;289:2379-86

NEJM 2002;347:716-25

JAMA 1995;273:1093-8

Circulation 2008;117: 614-22

PLOS 2008;5: e12.

Impact of exercise on weight

JAMA 2003;290:1323-30 

JAMA 2003;289:323-30

Exercise versus angioplasty

Circulation 2004;109:1371-8

Lifestyle prescription

J Fam Pract 2000;49:158-68

Am J Public Health 1998;88:288-91

Heart failure

J Am Coll Cardiol 2012;60:1521–8


JAMA 2009;301:1439-50 

Exercise based rehabilitation for heart failure

Cochrane CD003331

Exercise-based cardiac rehabilitation for coronary heart disease

Cochrane CD001800 


Can Fam Physician 2010;56:887

JAMA 2007;298:2296-2304

Other activity benefits

Cochrane 2002:CD003404

J Gerontol A Biol Sci Med Sci 2008;63:997-1004

J Sports Med Phys Fitness 2007;47:462-7

Cochrane 2008;CD004366

Cochrane 2008;CD004376

Calculator numbers

Eur J Cardiovasc Prev Rehabil 2008;15:239-46

Int J Environ Res Public Health 2012;9:391-407z



JAMA 2013;309:71-82

Lancet 2009;373:1083-96

Ann Intern Med 2003;138:24-32

Being a little bit overweight is OK

JAMA 2007;298:2028-2037

Lancet 2006;368:666-78

J Am Geriatr Soc 2005;53:2112-8

Metabolic syndrome – who cares?

Diabetes Care 2006;29:1693


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