geoffrey modest medical blogs

A recent huge real-world study (LEGEND-HTN) compared the effectiveness and safety of the major first-line antihypertensive drug classes initiated as monotherapy, finding that thiazide or thiazide-like diuretics were better than ACE inhibitors, and that non-dihydropyridine calcium channel blockers fared the least well (see htn monotherapy hctz lancet2019 in dropbox, or doi.org/10.1016/ S0140-6736(19)32317-7). Details: -- the authors developed a comprehensive framework for real-world evidence from several large databases, including six administrative claims and three electronic health record databases: IBM Market Scan databases for US employer-based private payers, Medicare supplemental beneficiaries, and multi-state Medicaid; Japan and South Korea national health databases; and the Optimum Pan Therapeutic US health systems, IMS/IQVIA disease analyzer from Germany, and the Columbia University Medical Center electronic record databases -- 4.9 million patients were included; ...

Healthy diet/antiinflammatories dec depression G      Geoff A. Modest, M.D. Wed 10/30/2019 8:18 AM Geoff A. Modest, M.D.  A recent Australian study found that depressed young adults stratified to a healthy diet had significantly fewer depressive symptoms 3 weeks later (see  depression improved with diet PLoS2019  in dropbox, or  doi.org/10.1371/ journal.pone.0222768 ). Details: --76 individuals participated in the study, all either for course credit in an undergraduate psychology course or for cash reimbursement via advertisement on the University campus area -- age 20, 63% female, BMI 22, current smokers 13%, comorbid disorders 25%, physical activity 5900 Mets, psychopharmacology 12%     -- there was no significant difference in baseline characteristics; though, in terms of their numbers, those in the Diet Change group had some more physical ac...