Nature reviews. Cardiology
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The majority of fatal cases of pulmonary embolism in hospitalized patients occur in acutely ill, medically treated patients. Current guidelines, based on a large number of prospective, randomized, controlled trials evaluating the safety and efficacy of pharmacologic venous thromboembolism (VTE) prophylaxis in medical patients, now recommend using VTE prophylaxis in this population. ⋯ Studies indicate that a substantial proportion of patients with VTE present after hospital discharge, but no clinical trials evaluating VTE prophylaxis for medical outpatients have yet been published. In this Review, we examine the literature on VTE prophylaxis in hospitalized medical patients, and evaluate the available data for the outpatient setting.
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Two or more drugs are needed to control blood pressure in the majority of patients with hypertension. The most commonly used combinations include a diuretic; however, results of two large, controlled trials show that better cardiovascular protection is provided by a combination of a renin-angiotensin inhibitor and a long-acting calcium-channel blocker than combinations that include a diuretic.