The American journal of medicine
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Evidence from meta-analyses shows that statin therapy reduces all-cause mortality and nonhemorrhagic strokes. Nonadherence to statins may reduce this protective effect. The association between statin adherence and incidence of cerebrovascular disease remains unexplored outside the context of clinical trials. ⋯ Our study suggests a relatively low level of adherence to statins, but more importantly, that adherence is associated with a risk reduction for cerebrovascular disease. Adherence to statin therapy needs to be improved, so that patients can benefit from the full protective effects of statin therapy.
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Osteoporosis commonly afflicts patients with inflammatory bowel disease, and many factors link the 2 states together. A literature review was conducted about the pathophysiology of osteoporosis in relation to inflammatory bowel disease. Screening guidelines for osteoporosis in general as well as those directed at patients with inflammatory bowel disease are reviewed, as are currently available treatment options. The purpose of this article is to increase physician awareness about osteopenia and osteoporosis occurring in patients with inflammatory bowel disease and to provide basic, clinically relevant information about the pathophysiology and guidelines to help them treat these patients in a cost-effective manner.
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Randomized Controlled Trial
The effect of a hypertension self-management intervention on diabetes and cholesterol control.
Most patient chronic disease self-management interventions target single-disease outcomes. We evaluated the effect of a tailored hypertension self-management intervention on the unintended targets of glycosylated hemoglobin (HbA1c) and low-density lipoprotein cholesterol (LDL-C). ⋯ There was a significant effect of the self-management intervention on the unintended target of HbA1c, but not LDL-C. Chronic disease self-management interventions might have "spill-over" effects on patients' comorbid chronic conditions.
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End-stage renal disease disproportionately affects black persons, but it is unknown when in the course of chronic kidney disease racial differences arise. Understanding the natural history of racial differences in kidney disease may help guide efforts to reduce disparities. ⋯ Racial differences in the risk of end-stage renal disease appear early in the course of kidney disease and are not explained by a survival advantage among blacks. Efforts to identify and slow progression of chronic kidney disease at earlier stages may be needed to reduce racial disparities.