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The Medical Literature
April 12, 2000

Users' Guides to the Medical Literature: XXI. Using Electronic Health Information Resources in Evidence-Based Practice

Author Affiliations

Author Affiliations: Department of Medicine (Drs Hunt and Jaeschke and Ms McKibbon) and Health Information Research Unit (Dr Hunt and Ms McKibbon), McMaster University, Hamilton, Ontario.


Users' Guides to the Medical Literature Section Editor: Drummond Rennie, MD, Deputy Editor (West).

JAMA. 2000;283(14):1875-1879. doi:10.1001/jama.283.14.1875

You are a general internist reviewing the condition of a 55-year-old woman with type 2 diabetes mellitus and hypertension. Her glycemic control is excellent with metformin, and she has no history of complications. To manage her hypertension, she takes a small daily dose of a thiazide diuretic. During the examination, you note that her weight is stable, she has no evidence of peripheral neuropathy, and her blood pressure is 155/88 mm Hg. After arranging for glycosylated hemoglobin, cholesterol, and microalbumin assessments, you reassure your patient that she is doing well and ask her to return in 3 months. After she has left, you notice that her blood pressure over the past 6 months has been about the same as it was today. You wonder if she would benefit from more aggressive blood pressure control. Specifically, in this patient with diabetes mellitus, would tighter blood pressure control improve survival or delay the onset of complications? You decide to find if the medical literature can help resolve the issue.

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