The Curbsiders podcast

#97 Hotcakes: Hypertension, Prostate Cancer Screening, Lifestyle & Mortality

May 28, 2018 | By

Keep current with this monthly journal club covering landmark articles through May 2018, plus rapid fire hot takes from the medical literature and health news. We rate each article according to a highly scientific ‘Hotcakes’ scale to highlight what practice-changing knowledge we’ll take to work this month. Topics: Hypertension, blood pressure monitoring, prostate cancer screening, Intimate Partner Violence screening, alcohol is killing you, new diabetes drugs and mortality, DPP-4 inhibitors and IBD risk, NT-proBNP-guided therapy vs usual care, effect of teaching status on mortality, and more! If you’re a listener and have something interesting for us to discuss, please send it our way.

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  • Written and produced by: Christopher J Chiu MD, Sarah Phoebe Roberts MPH
  • Hosts: Christopher J Chiu MD, Stuart Brigham MD, Paul Williams MD, and Matthew Watto MD
  • Editor: Matthew Watto MD

Part 1: Hotcakes! Main article reviews

Stuart: Blood pressure-lowering treatment strategies based on cardiovascular risk versus blood pressure. PLoS 2018 PMID: 29558462

  • Major takeaway: Framingham Risk Calculator sensitivity analysis: “The results, while qualitatively similar, had a lower area under the curve, suggesting worse performance of the CVD risk strategy using an externally derived prediction algorithm.” -Dr Brigham

Paul: Association of Repeated Measurements With Blood Pressure Control in Primary Care. Einstadter D et al. JAMA IM 2018

  • Major takeaway: Repeat the blood pressure at each office visit. Values are likely to be significantly lower on subsequent readings and not just because of “regression to the mean”. -Dr Williams
  • See also: Thomas Schwenk’s article on multiple blood pressure readings for HTN follow-up

Matt: Relationship between Clinic and Ambulatory Blood-Pressure Measurements & Mortality. Banegas JR et al. NEJM 2018.

  • Major takeaway: Look out for masked HTN, which confers the highest mortality. White coat HTN has a significant mortality risk that goes away with antihypertensive therapy. All phenotypes of HTN show a mortality benefit with BP treatment. -Dr Watto

Part 2: Hot Takes

“Hot Takes” are bite-sized summaries of recent articles and news headlines we thought our listeners might find interesting.

Guideline updates:

In the Lay News Media:

DPP-4 research:


  • Amy Orciari Herman’s Journal Watch article

Life in Medicine

  • 5 Lifestyle Factors Could Add More Than 10 Years to Life Expectancy (Li Y et al. Circulation. 2018)  
    1. Healthy Diet  
    2. Never Smoking  
    3. Moderate-to-vigorous physical activity (at least 30 min/day)
    4. Moderate alcohol consumption “We defined low-risk alcohol consumption as moderate alcohol consumption, for example, 5 to 15 g/d for women and 5 to 30 g/d for men.” -Y Li et al. Circulation. 2018  
    5. Healthy BMI

Part 3: Chiu’s Bites

  • Systematic review on Cefepime neurotoxicity from Open Forum Infectious Disease (was highlighted in Paul Sax’s blog)
  • Liberal vs Conservative Oxygen Therapy (IOTA review) – results support the conservative administration of oxygen therapy was beneficial in acutely ill adults.
  • 6 month update from ADRENAL study – In adult patients with septic shock, hydrocortisone did not affect mortality at 6 months, which is in keeping with previous publications.  
    • Great blog post from Patricia Kritek, MD about the ADRENAL, APROCCHSS, and SMART trials.  
  • 10 Things the ICU specialist needs to know about DOACs (and any internist) from Intensive Care Medicine  
  • History and Physical Exam Pearls (thanks to Tony Breu & Avital O’Glasser on Twitter!)    

Goal:  Listeners will keep current on the medical literature, health related news stories, and learn critical appraisal.

Learning objectives:
After listening to this episode listeners will…

Learn about the most important journal articles from the month and their salient points

Learn a practical approach to critical appraisal

Learn what medical news is being widely reported in the lay media and the underlying evidence in the literature

Disclosures: The Curbsiders report no relevant financial disclosures.

Time Stamps

  • 00:00 The Curbsiders need a webmaster
  • 00:50 Disclaimer
  • 01:25 Intro to the format
  • 03:25 Ambulatory BP monitoring and mortality
  • 09:08 Blood pressure treatment strategies: CVD risk score vs systolic BP targets
  • 14:14 Repeated BP measurements important at office visits and future directions of BP management
  • 21:25 Hot takes in order of appearance: Prostate cancer screening, intimate partner violence, alcohol, DPP4 inhibitors mortality and IBD, teaching status and mortality in US hospitals, 5 lifestyle factors that may add to life expectancy, NT pro-BNP, BNP and mortality
  • 38:12 Outro

Links from the show: See above. Links are embedded in each section.


  1. May 29, 2018, 3:04am Kenneth G Gould, jr MD PhD writes:

    Superb, understandable review with useable information that is not beaten to death by mathematics which are not carried to extreme at this time in the development of office & bedside medicine. Thank you.

  2. June 13, 2018, 11:35am Ali Anderson, Pharm.D. writes:

    Is there still a way we can download episodes from the website? I love your podcast! Thank you!

    • June 18, 2018, 12:48am Matthew Watto, MD writes:

      You should be able to - which episode are you having issues with?

      • June 18, 2018, 12:06pm Ali Anderson, Pharm.D. writes:

        I've been having issues with all of them lately. This is the one I was trying to download. There used to be an icon which allowed each episode to be downloaded, but i no longer see it. Thank you for your help!

        • June 18, 2018, 11:56pm Matthew Watto, MD writes:

          There is a rectangle with a down arrow in the top image/video bar of each episode - if you click on that it will download the episode directly from our site. I have tested this on past recent episodes as well and it has worked for me. Hope this helps.

        • June 19, 2018, 11:28am Ali Anderson, Pharm.D. writes:

          I can see it on the newer episodes. This one must just be the last one that shows up this way for me. No big deal, thank you!

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