geoffrey modest medical blogs

  A new Chinese study found that lowering the systolic blood pressure (SBP) to under 120mmHg in patients with high cardiovascular risk was associated with fewer vascular events and only a minor excess in adverse events (see htn BP lower than 120 better ESPRIT study Lancet2024  in dropbox, or doi.org/10.1016/ S0140-6736(24)01028-6)   Details : -- 11,255 hypertensive participants with high cardiovascular risk were enrolled in an open-label, blinded-outcome study from 116 hospitals or communities in China and randomized to a systolic blood pressure target of <120mmHg or <140mmHg from 2019-2020 -- participants were at least 50yo with high cardiovascular risk, defined as established cardiovascular disease or at least 2 major cardiovascular risk factors defined as being at least 60yo for men or 65yo for women, diabetes, dyslipidemia (defined as total cholesterol >200, or LDL >130, or HDL<40), and current smoker (defined as smoking >1 cigarette/day in past 12 months)

  A recent large prospective epidemiologic assessment found that taking aspirin decreased the incidence of colorectal cancer in people with less healthy lifestyles (see   aspirin dec colorectal cancer JAMAonc2024  in dropbox, or doi:10.1001/jamaoncol.2024.2503)   Details : -- 63,957 women from the Nurses’ Health Study (female nurses aged 30-55, from 1980-2018) and 43,698 men  from the Health Professionals Follow-up Study (males  aged 40-75, from 1986-2018), a total of 107,655 study participants, were assessed with data analyzed from 2021-2023     -- participants completed biennial questionnaires that included validated assessments of diet, lifestyle factors, medication use, and disease outcomes (including colorectal cancer: CRC), and had a 90% available person-time follow-up. The  dietary intake  was from a self-reported semiquantitative food frequency questionnaire every four years (dietary quality was defined as adherence to the six recommendations by the World Cancer Research Fund a