Annals of internal medicine
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Randomized Controlled Trial
Dogma disputed: can aggressively lowering blood pressure in hypertensive patients with coronary artery disease be dangerous?
Because coronary perfusion occurs mainly during diastole, patients with coronary artery disease (CAD) could be at increased risk for coronary events if diastolic pressure falls below critical levels. ⋯ The risk for the primary outcome, all-cause death, and MI, but not stroke, progressively increased with low diastolic blood pressure. Excessive reduction in diastolic pressure should be avoided in patients with CAD who are being treated for hypertension.
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Randomized Controlled Trial Multicenter Study Comparative Study
An evaluation of D-dimer in the diagnosis of pulmonary embolism: a randomized trial.
It may be safe to omit additional diagnostic testing in selected patients with suspected pulmonary embolism (PE) who have a negative D-dimer test, but this approach has never been evaluated in a randomized, controlled trial. ⋯ In patients with a low probability of PE who have negative D-dimer results, additional diagnostic testing can be withheld without increasing the frequency of VTE during follow-up. Low clinical probability and negative D-dimer results occur in 50% of outpatients and in 20% of inpatients with suspected PE.