It’s Never Too Late to Treat High Blood Pressure

New Feature Ask the Doctor

I've read a lot in the news in the last two weeks scary stuff about Singulair.  Should I stop taking it? -- Jeff K.

About two weeks ago the FDA released a communication that it was investigating the incidence of suicidal thinking and mood changes in patients taking Singulair, a medication used to treat asthma and nasal allergies.  No connection between Singulair and these symptoms has been est...
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Human Growth Hormone is Unproven to Improve Strength

Human growth hormone (HGH) has been receiving a lot of media attention recently because of the controversy of performance-enhancing drugs in baseball.  This made some researchers curious about how much evidence existed that HGH actually improves athletic performance.  They reviewed the scientific studies on HGH in an analysis published in the Annals of Internal Medicine.  The study received a lot of co...
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Even a Little Exercise is Better Than None

I am constantly encouraging patients to exercise.  Usually, the motivation is physical health -- the patient's weight, or blood pressure, or cholesterol, or sugar is too high and exercise is the healthiest way to normalize it.  But I'm increasingly impressed by the ability of exercise to improve mental health.  Patients tell me all the time that their mood is better, their anxiety lower, and their thinking sharper when they exercise than when they don't. A recent study adds evidence to that bel...
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What We Don’t Know About Diabetes

This week we learned something very important about diabetes.  We learned that we don't know something we thought we knew.  (Regular readers will note that this keeps happening in medicine.  For a generation everyone assumes something.  Then we check and discover it isn't so.) We've always assumed that in type 2 diabetes, the closer to normal that blood sugar is lowered the fewer complications of diabetes patients would have.  Why?  Because diabetes is known to be a major cause of kidney diseas...
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Laparoscopic Gastric Banding Can Cure Diabetes in Obese Patients

The scientific evidence for treatment of obesity is trending in a very interesting direction.  For years a safe and effective medication for weight loss has been sought, with only modest results.  (I wrote about orlistat, the medication in Xenical and Alli, a year ago.)  Surprisingly, for obese patients evidence is increasingly mounting in favor of surgery for weight loss, rather than medications or even diet and exercise. In 2006 ...
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More Bad News for Zetia and Vytorin

Regular readers will remember that I wrote about Zetia back in November.  That post had some important background for this week's news, and a handy lesson about the difference between clinical and intermediate outcomes in medical studies.  If you missed it, you may want to check it out.  This week, Merck released the data from a study comparing the growth of cholesterol plaques in the arteries of patients taking Zocor (a cholestero...
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The More Things Change

Change is always painful, even when everyone benefits from it.  We usually do our best to ignore slow trends, keeping our comfortable habits and pretending that the world will never surprise us.  I'm sure long after Ford started selling cars there were plenty of horse buggy makers who were sure that the car would always be an expensive frill for the very few. I don't think anything in the last 15 years has revolutionized our lives as much as the internet.  It has transformed how we shop, commun...
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Treatment for Localized Prostate Cancer: Many Options, Little Evidence

I've written before about the controversies in screening for and treating prostate cancer. Prostate cancer presents a unique challenge because it is extremely common, affects men who on average are older than patients with other cancers, and usually takes many years between diagnosis and disability or death.  In 2007, approximately 1 in 6 men in the United States were diagnosed with prostate cancer, and 1 ...
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