Evidence
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Lifestyle changes may be more important than drugs for mild hypertension

Consideration of wider risk factors may be important when treating adults with low-risk mild hypertension (raised blood pressure). A large NIHR-funded UK study compared rates of mortality and risk of cardiovascular disease between patients who received antihypertensive treatment and those who did not. There was an increased risk of adverse effects, like low blood pressure. ...

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Reviewing inhaler technique for older people with COPD can improve disease control

Educating older adults with chronic obstructive pulmonary disease or asthma about the correct way to use their inhalers, as part of disease management, can reduce their risk of exacerbations. Either a demonstration using a placebo inhaler or written information appears effective for this. This review pooled the results of four trials, with a total of ...

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Aerobic exercise is an effective treatment for depression

A systematic review shows aerobic exercise improves clinically diagnosed major depression compared with antidepressants or treatment as usual. Previous reviews found conflicting evidence of benefit. The new review only included the trials thought to have the most applicable results. This meant that trials recruiting people who might not have a clinical diagnosis of depression or ...

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Combining mirtazapine with other antidepressants is not effective for treatment-resistant depression

Adding mirtazapine to first-line antidepressants for adults with treatment-resistant depression does not improve symptoms when compared with placebo (dummy pills). People taking mirtazapine are more likely to experience side effects, and stop taking their treatment. This NIHR-funded trial took place in 106 general practices in England, recruiting 480 adults with mild to severe depression. All ...

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Adding low dose theophylline to inhaled corticosteroids does not reduce COPD exacerbations

Taking low-dose theophylline tablets in addition to inhaled corticosteroids did not significantly reduce chronic obstructive pulmonary disease flare-ups (exacerbations). This NIHR funded study found that people taking the combination and those taking an inhaled steroid had the same number of exacerbations - just over two per year. People who experience frequent exacerbations are often prescribed ...

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The benefits of commonly used blood pressure and cholesterol lowering treatment can last 16 years

Fewer deaths from stroke had occurred in people who had high blood pressure treated with amlodipine, a calcium-channel blocker, compared to atenolol, 10 years after the end of a large trial. People with high blood pressure who took statins were less likely to die from cardiovascular diseases, such as heart disease or stroke than those ...

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Thyroid hormone treatment does not help adults with mildly abnormal thyroid tests

There appears to be no benefit from treating adults with subclinical hypothyroidism. Treatment has no effect on quality of life or symptoms compared with placebo or no treatment. Thyroid function tests are commonly performed in general practice for patients who present with a range of symptoms, including fatigue or tiredness. When subclinical hypothyroidism is detected, ...

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Antidepressants do not help treat depression in people living with dementia

Antidepressants do not reduce symptoms of depression in people with dementia compared with placebo (dummy pills). Measured 6 to 13 weeks after starting the treatment, there is little or no difference in participants’ symptoms, but an increased chance of unwanted side effects. The review did not identify enough data to determine if antidepressants have an ...

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Home-based cardiac rehabilitation for heart failure has high rates of participation

Home-based cardiac rehabilitation for people with heart failure improves quality of life at 12 months compared with usual care. Among those allocated to rehabilitation, 90% remained in the programme – more than double average attendance rate for hospital-based rehabilitation. The average cost was estimated at £418 per participant which is within the National Health Service ...

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Repeat thyroid function tests for healthy older people are not needed

Older adults with normal thyroid function or subclinical thyroid dysfunction show notable long-term stability of their thyroid hormone levels. This suggests that it is safe for GPs not to routinely retest older adults unless they have risk factors or develop clinical symptoms of overt thyroid dysfunction. Over five years, about 0.2% older adults with normal ...

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