Abstract:
OBJECTIVE:To evaluate the 6-month change in cardiovascular (coronary heart disease) risk as a function of diet and drug therapy for mild hypertension. DESIGN:Collaborative randomized, controlled clinical trial to assess the efficacy of alternative regimens in treating mild hypertension. SETTING:Three university-based tertiary care centers-the Trial of Antihypertensive Interventions and Management (TAIM). PATIENTS:Six hundred and ninety-two men and women ages 21 to 65 years with diastolic blood pressure between 90 and 100 mm Hg and weight between 110% and 160% of ideal weight. MEASUREMENTS AND MAIN RESULTS:Patients stratified by clinical center and race were randomized into diet (usual, low sodium-high potassium, weight loss) and drug (placebo, chlorthalidone, and atenolol) groups resulting in nine diet plus drug combinations. The cardiovascular risk at 6-month follow-up was estimated relative to baseline in 692 participants using the Framingham Study model. Due to the blood pressure reduction, cardiovascular risk declined from baseline for all treatment groups (except the usual diet plus chlorthalidone group because of increased cholesterol levels). The relative cardiovascular risk at 6 months compared to baseline ranged from 0.83 in the weight loss plus atenolol subgroup to 1.03 in the usual diet plus chlorthalidone subgroup. The active drug plus weight loss groups showed the lowest relative cardiovascular risk at 6 months. CONCLUSIONS:Mild hypertension was generally reduced to desirable levels within 6 months by monotherapy. Evaluating blood pressure changes together with the risk factors indicated a differential effect on overall cardiovascular risk depending on the diet and drug used. Dietary therapy, particularly weight reduction, was important adjunctive treatment in reducing overall cardiovascular risk.
journal_name
Ann Intern Medjournal_title
Annals of internal medicineauthors
Oberman A,Wassertheil-Smoller S,Langford HG,Blaufox MD,Davis BR,Blaszkowski T,Zimbaldi N,Hawkins CMdoi
10.7326/0003-4819-112-2-89subject
Has Abstractpub_date
1990-01-15 00:00:00pages
89-95issue
2eissn
0003-4819issn
1539-3704journal_volume
112pub_type
临床试验,杂志文章,多中心研究,随机对照试验abstract::Within 4 days, two oncology patients in the Clinical Research Unit had bacteremia causes by group Y Neisseria meningitidis. Three additional patients, identified by prevalence survey, were found to have nasopharyngeal colonization with that serogroup, compared with only one employee (not associated with patients) and ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-91-1-7
更新日期:1979-07-01 00:00:00
abstract:Background:Patients desire information about health care costs because they are increasingly responsible for these costs. Public Web sites that offer cost information could inform provider-patient discussions of costs at the point of care. Objective:To evaluate tools to facilitate the use of publicly available cost in...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究
doi:10.7326/M18-2223
更新日期:2019-05-07 00:00:00
abstract:BACKGROUND:Travelers' diarrhea causes substantial morbidity and postinfectious irritable bowel syndrome. OBJECTIVE:To evaluate nonabsorbable rifaximin for prevention of travelers' diarrhea. DESIGN:Randomized, double-blind, placebo-controlled clinical trial. SETTING:Guadalajara, Mexico. PARTICIPANTS:U.S. students. ...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-142-10-200505170-00005
更新日期:2005-05-17 00:00:00
abstract::We report a case of combined idiopathic immune neutropenia and immune thrombocytopenia (thromboneutropenia). Therapy with prednisone was ineffective. Treatment with vincristine raised the patient's platelet count but did not increase the neutrophil count. Splenectomy led to a prompt complete remission. Using radioimmu...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-93-5-704
更新日期:1980-11-01 00:00:00
abstract::Medical technology assessment seeks to improve the care of individual patients (the conventional unit of clinical practice) through evaluation studies conducted in groups of patients (the conventional unit of clinical investigation). This distinction between individuals and groups has practical relevance to the design...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-118-6-199303150-00010
更新日期:1993-03-15 00:00:00
abstract::Cystic fibrosis was diagnosed after age 13 in 25 patients. All had an elevated sweat chloride and either a sibling with cystic fibrosis or typical pulmonary infection or digestive symptoms caused by exocrine pancreatic deficiency. Fourteen had long-standing pulmonary or digestive symptoms. In contrast, four of eight p...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-87-2-188
更新日期:1977-08-01 00:00:00
abstract:OBJECTIVE:To evaluate whether a brief course of treatment with gallium nitrate can reduce biochemical parameters of accelerated bone turnover in patients with advanced Paget disease. DESIGN:Unblinded trial, decreasing dose schedules of gallium nitrate. SETTING:University hospital with primary orthopedic and metabolic...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-113-11-847
更新日期:1990-12-01 00:00:00
abstract::Studies of circulating T- and B-lymphocyte rosettes were done in 20 healthy controls and 29 patients with pulmonary tuberculosis, including 18 receiving rifampin chemotherapy. Eight of the 18 patients in the rifampin group (44%) had significant suppression of their T-cell rosettes as compared with patients with tuberc...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-82-4-484
更新日期:1975-04-01 00:00:00
abstract::Four hemodialysis patients receiving deferoxamine for metal overload had fatal rhinocerebral rhizopus infections. Serious fungal infections are not commonly seen in patients on dialysis, and none of these patients had the usual risk factors for rhizopus infection. Deferoxamine is being used with increased frequency in...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-107-5-678
更新日期:1987-11-01 00:00:00
abstract::A group of 44 homosexual patients with immune thrombocytopenia and serologic evidence of infection with the human immunodeficiency virus (HIV) was observed for a total of 844 person-months. The risk of developing the acquired immunodeficiency syndrome (AIDS), an actuarial incidence of 36.5% in 37 months, was no differ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-106-3-383
更新日期:1987-03-01 00:00:00
abstract:BACKGROUND:Patients with chronic obstructive pulmonary disease (COPD) frequently develop exacerbations, leading to major clinical and health resource use ramifications. OBJECTIVE:To prospectively evaluate the effectiveness of a long-acting inhaled anticholinergic bronchodilator, tiotropium, in reducing COPD exacerbati...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-143-5-200509060-00007
更新日期:2005-09-06 00:00:00
abstract::Disturbances of urinary bladder function are well-recognized problems in diabetic patients and are generally attributed to peripheral neuropathy. Because of the difficulties inherent in the histologic examination of the peripheral autonomic nerves, little is known about the pathology of these nerves. Recently, alterat...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-92-2-316
更新日期:1980-02-01 00:00:00
abstract:Background:Delirium is common in hospitalized patients and is associated with worse outcomes. Antipsychotics are commonly used; however, the associated benefits and harms are unclear. Purpose:To conduct a systematic review evaluating the benefits and harms of antipsychotics to treat delirium in adults. Data Sources:P...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M19-1860
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:Vertebral fractures are a hallmark of postmenopausal osteoporosis and an important end point in trials of osteoporosis treatment, but the clinical significance of these fractures remains uncertain. OBJECTIVE:To determine the association of new vertebral fractures with back pain and back-related functional l...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-128-10-199805150-00001
更新日期:1998-05-15 00:00:00
abstract:OBJECTIVE:To determine whether low bone density and other risk factors for osteoporosis are associated with stress fractures in athletes. DESIGN:Case-control study. SETTING:Institutional sports injury clinic with primary and secondary care. PARTICIPANTS:Twenty-five athletes (nineteen women) with scintigraphically co...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-113-10-754
更新日期:1990-11-15 00:00:00
abstract::The competition for funds to conduct clinical research is intense, and only a minority of grant proposals receive funding. In particular, funding for patient-oriented research lags behind that allocated for basic science research. Grant writing is a skill of fundamental importance to the clinical researcher, and condu...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-142-4-200502150-00009
更新日期:2005-02-15 00:00:00
abstract:STUDY OBJECTIVE:To determine the efficacy of the addition of ifosfamide to cisplatin plus etoposide (VIP), or vinblastine (VeIP), in patients with recurrent germ cell tumors. DESIGN:Nonrandomized, prospective phase II trial. SETTING:Tertiary referral university hospital. PATIENTS:Fifty-six of fifty-eight entered pat...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-109-7-540
更新日期:1988-10-01 00:00:00
abstract::Ten patients with lupus nephritis and marked proteinuria (3.9 g or more/d) that did not respond adequately to treatment with prednisone alone or prednisone in combination with azathioprine were treated with total lymphoid irradiation in an uncontrolled feasibility study. Within 6 weeks after the start of total lymphoi...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-102-4-450
更新日期:1985-04-01 00:00:00
abstract::Between September 1972 and January 1976 an outbreak of dialysis dementia affected 20 patients maintained by long-term hemodialysis. The clinical picture was characterized by an insidious onset of altered behaviour, dementia, speech disturbance, myoclonus, and convulsions. Nineteen patients died, but one patient has su...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-88-4-502
更新日期:1978-04-01 00:00:00
abstract:OBJECTIVE:To examine the relation of obesity and weight loss to the formation of gallstones according to pertinent clinical and research issues. DATA SOURCES AND EXTRACTION:Original reports obtained through a MEDLINE search from 1966 to 1992 on gallstones plus obesity or reducing diets, supplemented by a manual search...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-119-10-199311150-00010
更新日期:1993-11-15 00:00:00
abstract::Thirty-five consecutives patients with classic or definite rheumatoid arthritis underwent echocardiography to evaluate the motion of the anterior mitral valve leaflet. Adequate echocardiograms were obtained in 31 patients. All 31 patients showed normal valve motion and a normal EF slope. If meticulous technique was no...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-83-4-500
更新日期:1975-10-01 00:00:00
abstract::Recent research on human macrophage activation has reemphasized the critical role of the lymphokine-secreting T cell in converting quiescent macrophages to efficient microbicidal phagocytes. Interferon-gamma, a key lymphokine secreted by antigen-triggered T4+ helper cells, is capable of inducing the macrophage to act ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-108-4-595
更新日期:1988-04-01 00:00:00
abstract:STUDY OBJECTIVE:To define the prevalence, severity, type and pathogenesis of osteopenia in idiopathic hemochromatosis. DESIGN:Prospective study conducted over 18 months. SETTING:Tertiary care center. SUBJECTS:Twenty-two men with idiopathic hemochromatosis and 20 age-matched controls. There were 5 hypogonadal patient...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-110-6-430
更新日期:1989-03-15 00:00:00
abstract:SOURCE CITATION:Mahady SE, Margolis KL, Chan A, et al. Major GI bleeding in older persons using aspirin: incidence and risk factors in the ASPREE randomised controlled trial. Gut. 2020. [Epub ahead of print.] 32747412. ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/ACPJ202101190-004
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:New tests, such as magnetic resonance imaging (MRI) and electron-beam computed tomography (CT), are being developed for the diagnosis of coronary artery disease. OBJECTIVE:To determine the conditions that a new test must meet to be a cost-effective alternative to established imaging tests. DESIGN:Decision ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析
doi:10.7326/0003-4819-131-9-199911020-00008
更新日期:1999-11-02 00:00:00
abstract::Deaths and injuries from firearms are significant public health problems, and clinicians are in a unique position to identify risk among their patients and discuss the importance of safe firearm practices. Although clinicians may be ill-prepared to engage in such discussions, an adequate body of evidence is available ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/AITC201906040
更新日期:2019-06-04 00:00:00
abstract:STUDY OBJECTIVE:To define the clinical and hematologic effects of recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) on patients with chronic severe neutropenia. DESIGN:Open-label, phase II study of rhGM-CSF. SETTING:Inpatient hematology and surgery clinic at a university medical center. P...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-111-11-887
更新日期:1989-12-01 00:00:00
abstract:BACKGROUND:Four months of rifampin treatment for latent tuberculosis infection is safer, has superior treatment completion rates, and is as effective as 9 months of isoniazid. However, daily medication costs are higher for a 4-month rifampin regimen than a 9-month isoniazid regimen. OBJECTIVE:To compare health care us...
journal_title:Annals of internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.7326/M19-3741
更新日期:2020-08-04 00:00:00
abstract::The irritable bowel syndrome is a common chronic disorder having a broad clinical spectrum of severity. Although only a small proportion of those afflicted seek medical help for their symptoms, a subset have severe and intractable symptoms. A positive diagnosis should be established from the history and physical exami...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-116-12-1009
更新日期:1992-06-15 00:00:00
abstract:BACKGROUND:ClinicalTrials.gov requires reporting of result summaries for many drug and device trials. PURPOSE:To evaluate the consistency of reporting of trials that are registered in the ClinicalTrials.gov results database and published in the literature. DATA SOURCES:ClinicalTrials.gov results database and matched ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M13-0480
更新日期:2014-04-01 00:00:00