JAMA : the journal of the American Medical Association
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Meta Analysis
The J-curve phenomenon and the treatment of hypertension. Is there a point beyond which pressure reduction is dangerous?
We critically appraised the medical literature to evaluate whether there is a point beyond which blood pressure reduction in hypertensive subjects is no longer beneficial and possibly even deleterious. Thirteen studies that stratified cardiovascular outcomes by level of achieved blood pressure in treated hypertensive subjects who had been followed up for at least 1 year were critiqued by four independent reviewers. ⋯ The beneficial therapeutic threshold point was 85 mm Hg. We conclude that low treated diastolic blood pressure levels, ie, below 85 mm Hg, are associated with increased risk of cardiac events.
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Biography Historical Article
The other Super Bowl question--can the NFL police its drug policy?
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In the United States, infant mortality risks among Hispanics have not been previously evaluated at the national level. We used the 1983 and 1984 national Linked Birth and Infant Death data sets to compare infant mortality risks among single-delivery infants of Hispanic descent with those among single-delivery infants of non-Hispanic whites (the reference group). ⋯ The postneonatal mortality risk (28 to 364 days) was highest among continental Puerto Ricans (RR = 1.2) and lowest among Cuban-Americans (RR = 0.6). Our study underscores the heterogeneity of the Hispanic population in the United States and suggests that interventions to prevent infant mortality be tailored to ethnic-specific risk factors and outcomes.