Friday, June 23, 2017

Guidelines 2017 for Interns: Hypertension, Hyperlipidemia, Diabetes

"Guidelines may be cookbook medicine, but what patients really need is a thinking cook."
(I don't know who said this originally, but if you find out, please let me know!)

The sad fact is much of what we do on a day-to-day basis in the practice of medicine is based on very little evidence.  

A good source for solid evidence-based resources is the United States Preventative Services Task Force recommendations.  You can find or download a set of tools as a part of the:
electronic Preventative Services Selector: ePSS.

Hypertension: Excellent overview
Viewpoint 2017: What is the right target?
Original 2014 Guideline: 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults
New Information: Sprint trial 
Additional Resources: 
American Family Physician: POEMsJNC 8 Report on Prevention, Evaluation and Treatment of Hypertension
AAFP: 2014 Hypertension Guideline Stands to Simplify Treatment, Says Expert

Hyperlipidemia2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults
American Heart Association: CV Risk Calculator
American College of Cardiology: ASCVD Risk Calculator
AAFP: New Guidelines Propose Significant Shift in Cholesterol Management

Diabetes: American Diabetes Association: Standards of Medical Care in Diabetes—2017
(including a link to the Abridged Standards for Primary Care Providers)
American Association of Clinical Endocrinologists: AACE Comprehensive Diabetes Management Algorithm 2017
Additional Resources: 
National Diabetes Education ProgramDiabetes Numbers at a Glance: 2016
CDC Diabetes Data & Trends

In addition, there are a number of "apps" that I think can be of use in clinic:

1) Agency for Healthcare Research & Quality: electronic Preventive Service Selector (ePSS)
2) Shots by STFM (Society or Teachers of Family Medicine)
3) American Heart Association/American College of Cardiology  ASCVD Risk Calculators (online)

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