Table of Contents

December 18, 2001; 135 (12)

Articles

  • The DASH (Dietary Approaches to Stop Hypertension) diet plus reduced sodium intake is recommended to control blood pressure in diverse subgroups of patients with hypertension.

  • Newspapers tended to overrepresent support for screening mammography for women 40 to 49 years of age. Reports would have been improved by identifying all sources for information cited, relying less on relatively few sources, and discussing benefits in absolute as well as relative terms. Medical journalism may benefit from identification of standards similar to those used for reporting medical research.

  • Widespread musculoskeletal pain is frequent among community-dwelling older women with disability and appears to predict the progression of disability. Efforts to better understand the cause of this pain and its treatment might reduce the overall burden of disability.

Brief Communications

  • Quinine is a common cause of drug-associated thrombotic thrombocytopenic purpura–hemolytic uremic syndrome (TTP–HUS) and can cause death and chronic renal failure. When the disorder is described as TTP–HUS rather than only as HUS, the severity of neurologic abnormalities and the occasional absence of renal failure are emphasized. To prevent recurrent disease, clinicians must recognize quinine as a possible cause.

Updates

  • This Update reviews studies that are important to physicians who care for medical inpatients. The research is grouped into six categories: pulmonary and critical care, infectious diseases, end-of-life care, cardiology, gastroenterology, and health care quality.

Review

  • Atrial fibrillation frequently complicates cardiac surgery, but many cases can be prevented with appropriate prophylactic therapy. A strategy of rhythm management for symptomatic patients and rate management for all other patients usually results in reversion to sinus rhythm within 6 weeks of discharge.

Perspectives

  • The authors address three questions: 1) Is blood pressure reduction a reliable marker for health benefits of antihypertensive drugs? 2) Does it matter how elevated blood pressure is decreased? 3) What types of antihypertensive clinical trials are needed in the future?

  • Achieving therapy goals in diabetic patients with hypertension usually requires several antihypertensive drugs. On the basis of their apparent superiority in slowing diabetic nephropathy, angiotensin-converting enzyme inhibitors should probably be the first choice. Second and third choices should be a long-acting diuretic and a calcium-channel blocker or a β-blocker, respectively.

Editorial

  • In this issue, two perspectives highlight recent evolutions of thought regarding pharmacologic treatment for people with hypertension. In addition to pharmacologic advice, this issue also features an important report from Vollmer and colleagues on a long-debated lifestyle intervention: dietary salt restriction.

On Being a Doctor

  • Mr. P. appreciated that newspaper more than all of the things that we were doing to preserve his life. The news that he got from the paper was stuff he understood—ERA, batting averages, standings, games behind or ahead, not squamous cell carcinoma or surgical debulking.

Letters

Medical Writings: Book Notes

Current Clinical Issues

Thanks to Reviewers

Book Listings

Medical Notices

Summaries for Patients