Treating patients to lower than st and ard BP targets , < /=140 - 160/90 - 100 mmHg , does not reduce mortality or morbidity .
BACKGROUND When treating elevated blood pressure , doctors need to know what blood pressure ( BP ) target they should try to achieve .
The st and ard of clinical practice for some time has been < /= 140 - 160/ 90 - 100 mmHg .
New guidelines are recommending BP targets lower than this st and ard .
It is not known whether attempting to achieve targets lower than the st and ard reduces mortality and morbidity .
OBJECTIVES To determine if lower BP targets ( < /= 135/85 mmHg ) are associated with reduction in mortality and morbidity as compared with st and ard BP targets ( < /= 140 - 160/ 90 - 100 mmHg ) .
Statin Adherence and Risk of Accidents: A Cautionary Tale
Background — Bias in studies of preventive medications can occur when healthier patients are more likely to initiate and adhere to therapy than less healthy patients . We sought evidence of this bias by examining associations between statin exposure and various outcomes that should not be causally affected by statin exposure , such as workplace and motor vehicle accidents . Methods and Results — We conducted a prospect i ve cohort study of  statin patients using data from British Columbia , Canada , a multiethnic society with a population of 4.3 million people . Study subjects were 141 086 patients who initiated statins for primary prevention . We examined the association between adherence and multiple outcomes such as accidents and screening procedures using multivariable-adjusted Cox proportional hazards models . The study population was 49 % female and had an average age of 61 years . The results from our multivariable-adjusted models showed that more adherent patients were less likely to have accidents than less adherent patients . This effect was greatest for motor vehicle accidents ( hazard ratio , 0.75 ; 95 % confidence interval , 0.72 to 0.79 ) and workplace accidents ( hazard ratio , 0.77 ; 95 % confidence interval , 0.74 to 0.81 ) . More adherent patients had a greater likelihood of using screening services ( hazard ratio , 1.17 ; 95 % confidence interval , 1.15 to 1.20 ) and a lower likelihood of developing other diseases likely to be unrelated to a biological affect of a statin ( hazard ratio , 0.87 ; 95 % confidence interval , 0.86 to 0.89 ) . Conclusions — Our study contributes compelling evidence that patients who adhere to statins  are systematic ally more health seeking than comparable patients who do not remain adherent . Caution is warranted when interpreting analyses that attribute surprising protective effects to preventive medications
Treating patients to lower than st and ard BP targets , < /=140 - 160/90 - 100 mmHg , does not reduce mortality or morbidity .
BACKGROUND When treating elevated blood pressure , doctors need to know what blood pressure ( BP ) target they should try to achieve .
The st and ard of clinical practice for some time has been < /= 140 - 160/ 90 - 100 mmHg .
New guidelines are recommending BP targets lower than this st and ard .
It is not known whether attempting to achieve targets lower than the st and ard reduces mortality and morbidity .
OBJECTIVES To determine if lower BP targets ( < /= 135/85 mmHg ) are associated with reduction in mortality and morbidity as compared with st and ard BP targets ( < /= 140 - 160/ 90 - 100 mmHg ) .