Arch Intern Med
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Performance measures that reward achieving blood pressure (BP) thresholds may contribute to overtreatment. We developed a tightly linked clinical action measure designed to encourage appropriate medical management and a marker of potential overtreatment, designed to monitor overly aggressive treatment of hypertension in the face of low diastolic BP. ⋯ While 94% of diabetic veterans met the action measure, rates of potential overtreatment are currently approaching the rate of undertreatment, and high rates of achieving current threshold measures are directly associated with overtreatment. Implementing a clinical action measure for hypertension management, as the Veterans Health Administration is planning to do, may result in more appropriate care and less overtreatment.
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Review Meta Analysis
Smoking and all-cause mortality in older people: systematic review and meta-analysis.
BACKGROUND Smoking is an established risk factor of premature death. However, most pertinent studies primarily relied on middle-aged adults. We performed a systematic review and meta-analysis of the empirical evidence on the association of smoking with all-cause mortality in people 60 years and older. ⋯ Benefits of smoking cessation were evident in all age groups, including subjects 80 years and older. CONCLUSIONS Smoking remains a strong risk factor for premature mortality also at older age. Smoking cessation is beneficial at any age.