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MedicalResearch.com Interview with: George Hripcsak, MD, MS. Chair and Vivian Beaumont Allen Professor of Biomedical Informatics Department of Biomedical Informatics, Columbia University Irving Medical Center New York, NY MedicalResearch.com: What is the background for this study? Response: ACE inhibitors and ARBs are anti-hypertension drugs that have related yet distinct mechanisms of action, and they are both recommended as first-line therapies for treating hypertension. There have been no large head-to-head comparisons of ACE inhibitors and ARBs, although there are several studies with limited size and often restricted (e.g., high-risk) populations. While there are some conflicting results in the literature, the current evidence seems to indicate that they are similar in effectiveness but that ACE inhibitors have more side effects (e.g., cough and angioedema). MedicalResearch.com: What are the main findings? Response: We confirmed that in our population of first-time anti-hypertension drug users, effectiveness was similar and that ACE inhibitors did indeed have more side effects. Cough and angioedema were clear. Pancreatitis and gastrointestinal bleed were also detected but did not pass the strict Bonferroni criteria, meaning that the differences for these latter two could still be due to chance. MedicalResearch.com: What should readers take away from your report? Response: Our report indicates that new hypertension patients should favor ARBs instead of ACE inhibitors. We did not study patients already taking anti-hypertensive medications, so our results do not directly pertain to patients switching drugs, and if patients are already tolerating their current anti-hypertensive medications well, our study does not point to changing. MedicalResearch.com: What recommendations do you have for future research as a result of this work? Response: Future research should look at subgroups of patients who may see a difference in benefit between the two drug classes, and look at specific drugs within the classes. Any disclosures? This study was funded in part by the National Institutes of Health and the National Science Foundation. Two authors are employees of Janssen Research and Development with interests in Johnson & Johnson, and the paper enumerates additional disclosures for the authors. Citation: Comparative First-Line Effectiveness and Safety of ACE (Angiotensin-Converting Enzyme) Inhibitors and Angiotensin Receptor Blockers: A Multinational Cohort Study RuiJun Chen, Marc A. Suchard,  Harlan M. Krumholz, Martijn J. Schuemie Steven Shea, Jon Duke, Nicole Pratt, Christian G. Reich, David Madigan, Seng Chan You, Patrick B. Ryan, George Hripcsak Originally published26 Jul 2021https://doi.org/10.1161/HYPERTENSIONAHA.120.16667 Hypertension. ;0:HYPERTENSIONAHA.120.1666  The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.   Read the full article

Dr. Spotnitz Matthew E. Spotnitz, MD, MPH Departments of Biomedical Informatics and Obstetrics and Gynecology Columbia University Medical Center Observational Health Data Sciences and Informatics, and Medical Informatics Services New York-Presbyterian Hospital, New York, New York MedicalResearch.com: What is the background for this study? Response: Our take home message is that copper and hormonal IUDs may have different physiological effects on the female genitourinary system. MedicalResearch.com: What are the main findings? Response: Consequently, the risk of cervical neoplasms may be different for copper and hormonal IUD users. MedicalResearch.com: What should readers take away from your report? Response: Our findings may help patients and healthcare providers make informed decisions about whether the benefits of hormonal IUD use, compared to copper IUD use, are greater than the risks.  MedicalResearch.com: What recommendations do you have for future research as a result of this work?  Response: We intend to run this analysis on other databases in the Observational Health Data Sciences and Informatics (OHDSI) network.  No disclosures  Citation: Relative Risk of Cervical Neoplasms Among Copper and Levonorgestrel-Releasing Intrauterine System Users Spotnitz, Matthew E. MD, MPH; Natarajan, Karthik PhD; Ryan, Patrick B. PhD; Westhoff, Carolyn L. MD, MSc Obstetrics & Gynecology: February 2020 - Volume 135 - Issue 2 - p 319-327 doi: 10.1097/AOG.0000000000003656 https://journals.lww.com/greenjournal/fulltext/2020/02000/relative_risk_of_cervical_neoplasms_among_copper.11.aspx The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.   Read the full article

Dr. Hripcsak George Hripcsak, MD, MS Vivian Beaumont Allen Professor of Biomedical Informatics Chair, Department of Biomedical Informatics Columbia University Director, Medical Informatics Services NewYork-Presbyterian Hospital/Columbia MedicalResearch.com: What is the background for this study? Response: Diuretics are considered among the best drugs to treat hypertension, but there are no randomized studies to tell us which diuretic is best. Hydrochlorothiazide is the most frequently used diuretic for hypertension, but another drug, chlorthalidone, is gaining favor, with the most recent US hypertension guideline expressing a preference for it. Chlorthalidone is known to be longer acting and therefore perhaps more effective. Other (non-randomized) studies have been inconsistent, and some of them imply that chlorthalidone may be more effective. But other studies have shown that chlorthalidone may have more side effects. MedicalResearch.com: What are the main findings?  Response: We carried out the largest and--we believe--most sophisticated non-randomized study comparing the two drugs, and we found little difference in effectiveness (preventing heart attacks, strokes, and heart failure) but we found that chlorthalidone produces more side effects, especially low potassium (almost three times as much) and other electrolyte disorders and kidney problems.  MedicalResearch.com: What should readers take away from your report?  Response: We believe that if you are already taking hydrochlorothazide, our study shows no reason to switch to chlorthalidone at this time. And if you are taking chlorthalidone, your physician should be monitoring your electrolytes and kidney function carefully.  MedicalResearch.com: What recommendations do you have for future research as a result of this work?  Response: A large randomized study to compare the two drugs is currently in progress and may reveal more information in a few years. Even so, our study is reflective of what happens in real world practice. Disclosures: This study was funded in part by the US National Institutes of Health and the National Science Foundation. George Hripcsak has received grant funding from Janssen Research through his university to support methods research not directly related to this study. Janssen did not have input in the design, execution, interpretation of results, or decision to publish. Citation: Hripcsak G, Suchard MA, Shea S, et al. Comparison of Cardiovascular and Safety Outcomes of Chlorthalidone vs Hydrochlorothiazide to Treat Hypertension. JAMA Intern Med. Published online February 17, 2020. doi:10.1001/jamainternmed.2019.7454 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2760777 The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.   Read the full article

tilt wednesday? or the best day ever when the show photographer gets the exact shot you want? . . 📸: @joannama13 #dancehaven #columbiamed @dancehaven (at New York, New York) https://www.instagram.com/p/BrlncLYAbaM/?utm_source=ig_tumblr_share&igshid=15mjh0vhk9tw5

Jennifer Woo Baidal, MD, MPH Assistant Professor of Pediatrics Director of Pediatric Weight Management, Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Columbia University Medical Center & New York-Presbyterian Morgan Stanley Children’s Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Childhood obesity prevalence is historically high, with most incident obesity among children occurring before age 5 years. Racial/ethnic and socioeconomic disparities in childhood obesity are already apparent by the first years of life. Latino/Hispanic children in low-income families are at-risk for obesity. Thus, understanding potentially effective ways to prevent childhood obesity, particularly in vulnerable populations, should focus on early life. Sugar-sweetened beverage (SSB) consumption is a modifiable risk factor for obesity and is linked to other adverse health outcomes. Maternal SSB consumption in pregnancy and infant sugar-sweetened beverage consumption in the first year of life are linked to later childhood obesity. We sought to describe beverage consumption in a modern cross-sectional cohort of 394 low-income, Latino families, and to examine the relationship of parental attitudes toward sugar-sweetened beverages with parental and infant SSB consumption. MedicalResearch.com: What should readers take away from your report? Response: In this cohort of WIC-enrolled families in the first 1,0000 days, we found that 89% of parents and 30% of infants habitually consumed sugar-sweetened beverages. More negative parental attitudes towards SSBs were associated with fewer SSB calories consumed by parents and lower likelihood of infant SSB consumption.  MedicalResearch.com: What recommendations do you have for future research as a result of this work? Response: Efforts to curb sugar-sweetened beverage consumption during pregnancy and infancy are needed. Interventions that include messaging to influence parental attitudes towards SSB consumption should be tested during the first 1,000 days in order to promote healthy infant nutrition and growth.  MedicalResearch.com: Is there anything else you would like to add?  Response: Research reported in this publication was supported by the National Institute Of Diabetes And Digestive And Kidney Diseases of the National Institutes of Health under Award Number K23DK115682, K24KD10589, and Robert Wood Johnson Foundation New Connections Grants Through Healthy Eating Research Program (RWJF Grant #74198). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or any of the other funders.  Citation: Sugar-Sweetened Beverage Attitudes and Consumption During the First 1000 Days of Life Nutrition/Food, Obesity, Overweight, Underweight, Child and Adolescent Health, Race/Ethnicity, Low-Income Children, Family Health, Maternal and Infant Health, Hispanics/Latinos Jennifer A. Woo Baidal, Kayla Morel, Kelsey Nichols, Erin Elbel, Nalini Charles, Jeff Goldsmith, Ling Chen and Elsie Taveras Ahead of Print 25 Oct 2018 The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.   Read the full article

My sister is a TRIPLE Ivy League graduate - I brag different! 😜🎓 #Columbia #HarvardMPH #ColumbiaMed (at Columbia University Vagelos College of Physicians and Surgeons)