News from the Annals of Internal Medicine, Jan. 14, 2014
1. Panel at odds over newly released blood pressure guidelines
Panel members explain why they voted against raising systolic blood pressure targets
Some panel members are speaking out against the decision to raise the threshold at which older adults begin taking medication to control their blood pressure. In a commentary published in Annals of Internal Medicine, members of the Institute of Medicine's Eighth Joint National Committee, or JNC 8, explain why they voted against relaxing systolic blood pressure targets to 150 mmHg for patients aged 60 and older without diabetes or chronic kidney disease (CKD). Opposing panel members submitted the editorial because they say published guidelines did not adequately explain their concerns. They argue that evidence for raising the systolic blood pressure target was insufficient and that doing so will likely reduce the intensity of antihypertensive treatment in a large population of people at high risk for cardiovascular disease (CVD), potentially reversing the decades long decline in CVD, especially stroke mortality.
2. Task Force makes final recommendations on screening for gestational diabetes
The U.S. Preventive Services Task Force recommends screening asymptomatic pregnant women for gestational diabetes mellitus (GDM) after 24 weeks gestation, according to a recommendation being published in Annals of Internal Medicine. GDM puts babies at risk for having a high birth weight and low blood sugar, and puts expectant mothers at risk for pregnancy, labor, and birth complications including preeclampsia. Women who are diagnosed with GDM can control their glucose levels and decrease risks for complications, making screening an important consideration. The researchers found insufficient evidence to assess the balance of benefits and harms of screening for GDM in asymptomatic women before 24 weeks gestation. This is an update to a previous recommendation. In 2008, the Task Force found insufficient evidence to recommend for or against screening for GDM in asymptomatic pregnant women.