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This Week in JAMA
December 3, 2003

This Week in JAMA

JAMA. 2003;290(21):2769. doi:10.1001/jama.290.21.2769

Hypertension is a risk factor for progression of coronary artery disease (CAD). Pepine and colleaguesArticle conducted a randomized controlled trial among patients aged 50 years or older with hypertension and CAD to compare outcomes of 2 multidrug blood pressure management strategies: a verapamil-trandolapril–based strategy and an atenolol-hydrochlorothiazide–based strategy. During a mean follow-up of 2.7 years, there were no significant differences in the primary composite outcome of all-cause mortality, nonfatal myocardial infarction, or nonfatal stroke between the treatment strategies. In an editorial, AldermanArticle discusses ways to improve cardiovascular disease prevention in both research studies and clinical practice.

The benefits of solitary pancreas transplant for diabetes mellitus remains controversial. Venstrom and colleaguesArticle compared the posttransplantation survival of patients with preserved renal function who received either a pancreas alone or a pancreas-after-kidney transplant with similar patients on the organ donor wait list during 1995-2000. After 4 years of follow-up, patients who received a solitary pancreas transplant had worse survival compared with patients who continued to receive conventional insulin therapy. In a commentary, NathanArticle discusses the known risks and benefits of isolated pancreas transplantation and urges diligent attention to patient selection criteria.