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18 December 2001 Annals of Internal Medicine Tip Sheet

Annals of Internal Medicine is published by the American College of Physicians-American Society of Internal Medicine (ACP-ASIM), an organization of more than 115,000 internal medicine physicians and medical students. The following highlights are not intended to substitute for articles as sources of information. For an embargoed fax of an article, call 1-800-523-1546, ext. 2656 or 215-351-2656.

Controlling Hypertension Three Ways

Three articles in the December 18 issue of Annals of Internal Medicine address controlling hypertension. Reviewing current scientific evidence, an author outlines five principles for managing hypertension in patients with Type 2 diabetes (Perspective, p. 1079). Other authors find that not all blood pressure lowering drugs are equal (Perspective, p. 1074). Antihypertensive drugs have different physical and clinical effects, some of which are independent of their effects on blood pressure. These findings have potential implications for regulatory approval of antihypertensive drugs as well as for selecting drugs to treat individual hypertensive patients, these authors say. A new analysis of data from a dietary study finds that a diet high in fresh fruits and vegetables and low in saturated fats (the DASH diet) lowered blood pressure, as did a diet low in sodium (Article, p. 1019). The combination of the DASH diet and reduced sodium lowered blood pressure more than either alone. An editorial says that drug therapies - not diet - have clearer proven clinical benefits in lowering blood pressure (Editorial, p. 1084). But the writer says that "people may benefit from and are unlikely to be harmed by" the advice to eat fresh fruit and vegetables; don't add salt during cooking or at the table, and avoid preprocessed prepared foods. (This month's Internal Medicine Report video news release discusses the article on the DASH-low-sodium diet.)

Newspaper Articles on Mammography Seldom Accurate or Complete

A study of 225 articles on mammography in six major newspapers in the United States found a gap between scientific evidence and reporting (Article, p. 1029). Most of the articles focused on and supported mammography for women between the ages of 40 to 49, even though scientific evidence is uncertain about the benefits for women in this age group. One-third of the articles didn't say where their information had come from; most rarely gave the recommendations of national authorities and tended to overstate the potential benefit of mammography for women aged 40 to 49. Authors say that the public would be better served if newspaper reporting attributed information to identifiable sources, avoided over-representation of particular points of view, and disclosed possible conflicts of interest of the expert sources they interview.

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