Sheppard JP, Burt J, Lown M et al. Treating BP levels in older people is not merely a question of lowering mean pressure levels. Guyatt GH. The recent OPTIMISE trial investigated the effect of antihypertensive medication reduction versus usual care on short-term BP control in patients aged 80 years and older [5]. Evidence-based medicine. As the articles in this issue make clear, EBM is a powerful tool with the potential to improve clinical decision making and, ultimately, the health of patients. Lying and standing blood pressure should be recorded in patients >65 years. Systematic research evidence is more abundant and accessible than ever before, and EBM provides an original framework for integrating the results of this research into clinical practice [10]. We deal with a relatively novel and extremely heterogeneous category of patients, with frequent haemodynamic postural disorders, challenging co-morbidities, often incident side effects of medications and, eventually, different degrees of vitality at same categories of age. Elevated blood pressure ACP J Club. Medicine Is A Science Of Uncertainty And An Art Of Probability Blank Lined Notebook ( Doctor ) Green Posted June 27th 2020 at 23:23 by nejy Valarie Blake examines a related issue: the role of clinical practice guidelines in the courts. For full access to this pdf, sign in to an existing account, or purchase an annual subscription. Medicine is a science of uncertainty and an art of probability (Sir W. Osler). Association of American Medical Colleges. 108 pages, high quality cover and (6 x 9) inches in size. Whose interests should be considered in the interpretation and dissemination of research evidence? Prasad V, Cifu A, Ioannidis JP. Sir William Osler: Aphorisms from his Bedside Teachings and Writings. The findings of this study have had a crucial role in adapting guidelines in older patients. Meldolesi E(1), van Soest J(2), Dinapoli N(3), Dekker A(2), Damiani A(3), Gambacorta MA(3), Valentini V(3). However, at least two issues need to be discussed: first, the long-term effects of this intervention are unknown; second, investigators and participants were not blinded; therefore, this might have influenced the results. Recent discussions about EBM particularize the importance of “decision aids” and other means by which patients participate in their own treatment [6, 7]. Justice: Who should have the authority to prioritize research questions and funding? Therefore, measurement of standing BP should be routinely done in older patients. In this population, there was an inverse relationship between baseline SBP levels and all-cause mortality.
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