SPRINT prompts new debate on BP targets

This issue covers topics such as management of hypertension, integrative medicine, and follow-up care for colorectal cancer.


Best practices in hypertension management have been a moving target as of late, and recent results from SPRINT (Systolic Blood Pressure Intervention Trial) have provided further food for thought. While previous trials seemed to be moving practice away from the “lower is always better” philosophy regarding systolic blood pressure, SPRINT, with its significant cardiovascular benefits, may be swinging the therapeutic pendulum back again. Our story this issue looks at what this means for primary care, covering why SPRINT's exclusions are important and ways in which the current evidence can and should be applied to individual patients.

Integrative medicine has undergone a “sea change” recently, according to one expert, with more therapies and techniques making their way into mainstream medicine. This may be driven in part by research and in part by an effort to find more ways to treat intractable conditions like chronic pain. In our story , staff writer Mollie Durkin provides an overview of how the field formerly known as CAM, or complementary and alternative medicine, is evolving and what that means for internists in clinical practice.

Colorectal cancer survivors who have completed treatment are in need of specific follow-up from their primary care physicians. Recent guidelines from the American Cancer Society highlight the main areas to be covered, including recurrence surveillance, screening for second primary cancer, and physical and psychological long-term and late effects of the disease and its treatment. Communication with and good handoff from a patient's oncologist is often another key to quality follow-up care, as our story explains.

Alzheimer's disease can be one of the more frustrating diseases to manage, because, as experts explain in our story , none of the available therapies offer much benefit. New therapies targeting early-stage disease are currently in clinical trials but are not guaranteed to be successful, and in the meantime internists must provide the best care possible for their patients with Alzheimer's disease. Our story provides an overview of the treatments available now, including how and when to prescribe them, as well as advice on addressing symptoms and helping patients and caregivers alike manage the manifestations of the disease.

Finally, Internal Medicine Meeting 2016 will take place this year in Washington, D.C., from May 5-7. Highlights this year include discussions of clinical controversies, a free half-day precourse on opioid prescribing, and the opportunity to join colleagues on Capitol Hill as part of Leadership Day. We hope to see you there!

Sincerely,

Jennifer Kearney-Strouse