(or How I Learned To Stop Worrying and Love the Pharmaceutical Industry)
I'd like to try to change the way you think about preventative medications.
The goal of prescribing blood pressure-lowering medications is not to lower blood pressure. The goal of prescribing cholesterol-lowering medications is not to lower cholesterol. The goal of prescribing medications for osteoporosis (low bone density) is not to raise bone density. Let me explain. The goal of medications that low...
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Turning that Frown Upside-down
A patient of mine told me yesterday that she thought too many of my posts were negative: this supplement doesn't help, that medication doesn't work, this intervention doesn't make a difference. She's right. A lot of my posts are negative. There are two reasons for that. One is that we're constantly bombarded by advertisement and bogus information in the mass media about the latest and greatest medical wonder, usually long before any evidence exists about its effectiveness. So I partially s...
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Statins Have Long-Lasting Benefits
The West of Scotland Study was a landmark in preventive medicine. It was published in the early 1990s and was the first study to definitively show that statins (a family of cholesterol-lowering medicines) could prevent a first heart attack in people with high cholesterol. It randomized over 6,000 middle-aged men with high cholesterol who had never had a heart attack to either pravastatin (Pravachol) or placebo. In about 5 years of follow up, pravastatin clearly prevented heart attacks and sav...
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Ignore Epidemiology, Maybe It’ll Go Away
My regular readers (both of them) have noticed that I spend almost as much time writing about new studies you should ignore as about new studies you should pay attention to. That's because the media is driven by hype, not by sober science, and there's no incentive for an editor to get rid of a story just because the study is misleading or meaningless. (I'm not complaining. That's a consequence of having a free press, and it's muc...
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Vitamin D Deficiency is Common and Dangerous
Two weeks ago I warned you about excessive sun exposure. Ironically, this week I'm warning you about a consequence of insufficient sun exposure.
A recent article in the New England Journal of Medicine exposes a very common and under-diagnosed problem, vitamin D deficiency. This has become a bigger problem as our activities have moved incr...
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Antimicrobial Soap no Better than Plain
In our germ-phobic culture antimicrobial soap, once only used in hospitals, has become very popular in households. This issue of the journal Clinical Infectious Diseases contains a study which reviews the literature comparing antimicrobial soaps versus plain soap. The results of the study was reported in many media articles, including More
More Studies to Ignore
I wrote back in January about the large numbers of studies that are publicized in the media that doctors and patients are better off ignoring. I usually try not to give these studies any attention, but this week a study got so much media coverage that I felt I had to tell you all to ignore it.
This study in the journal Circulation
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Don’t Panic about Avandia Yet
A new study in the New England Journal of Medicine has generated a lot of media attention this week (such as this NY Times article). The study pooled prior randomized studies that compared patients taking the diabetes medicine Avandia (ro...
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Getting Better at Treating Heart Attacks
Though heart attacks continue to be the number one cause of death in the United States, the news for treatment and prevention of heart disease keeps getting better. An article in this issue of The Journal of the American Medical Association examines the rates of death in a multinational study of heart attacks and heart-related acute chest pai...
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You Can Probably Stop Taking Antibiotics before Seeing Your Dentist
Many patients have been told to take antibiotics before dental procedures. This recommendation was made to prevent an infection of the lining or valves of the heart called infective endocarditis (IE). Patients who had leaky heart valves or other heart conditions that were thought to increase the risk of IE were told to take antibiotics before seeing the dentist.
Last week the American Heart Association p...
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