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Embargoed news from Annals of Internal Medicine
Date:10/19/2009

veness in patients with low testosterone levels. Physicians should individualize decisions to measure hormone levels based on the clinical symptoms (e.g., decreased libido, premature ejaculation, fatigue, etc.) and physical findings (for example, testicular atrophy, muscle atrophy) that suggest hormonal abnormality.

Note: Embargoed video of Dr. Qaseem discussing the guideline is available at www.media.dssimon.com/taperequest/acp56.php.

2. Adding ACE Inhibitors to Standard Care Improves Outcomes for Stable Ischemic Heart Disease Patients; Adding ARBs Does Not Help, Increases Harms

Ischemic heart disease (IHD) is the leading cause of death of both men and women in the United States. IHD is the lack of blood supply to the heart muscle caused by coronary artery disease and heart attacks. Traditionally, IHD is treated with aspirin, beta-blockers, and aggressive modification of risk factors. Angiotension-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs) are introduced when patients have heart failure or a heart attack with ventricular dysfunction. However, these treatments typically are not used on patients with preserved ventricular function. Researchers reviewed 41 published studies to compare the benefits and harms of using ACE inhibitors, ARBs, or a combination of these treatments in adults with stable IHD and preserved ventricular function. The researchers found that adding ACE inhibitors to standard treatment improves clinical outcomes in these types of patients. A combination of ACE inhibitors and ARBs appeared no better than ACE inhibitor therapy alone and increased harms. The researchers recommend future trials to more clearly define the role for ARBs in this population.

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3. HPV Vaccination Not Cost Effective for Women Older in their 30s and 40s

Most cases of cervical cancer are caused by certain s
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Contact: Angela Collom
acollom@acponline.org
215-351-2653
American College of Physicians
Source:Eurekalert

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