New trials

I read a lot of journal articles (hundreds per year).  I keep an eye out for research that either shows a concrete clinically meaningful benefit for older adults or studies that show a lack of benefit.  At the end of the day, that's all I care about.  Studies that show an intermediary benefit or a lack of it (like a blood test result, an imaging result) are interesting but show me nothing.

A couple of things:
Aspirin is falling out of favor for preventing a first heart attack or stroke.  A Japanese study showed that for low risk patients who have not had a heart attack or stroke, taking an aspirin did little to prevent a first event and the benefits were outweighed by having a bleeding stroke or major intestinal bleed.

Most older adults with heart failure due to stiffness of the heart (Diastolic CHF) are often tried on medications called betablockers or ACE inhibitors because they are wonderfully effective for heart failure due to improper squeezing of the heart (Systolic CHF).  Unfortunately, they don't do anything for Diastolic CHF.  And it contributes to polypharmacy.

For Diabetes, many people think of sugar like they think of taxes.  The lower the better.  Unfortunately while that may make sense in theory for Diabetes, it simply also isn't true.  A new study continues to hammer away that lower is always better.  The benefit has diminishing returns as A1C gets below 9.  The pain of getting to an A1C below 9 involves more medications, hypoglycemic episodes and isn't safe.  So for the risk of adding dangerous side effects, with minimal benefit, most patients older than 50 experience a net harm for getting their sugar less than 9.

Finally for something that actually is beneficial, a new report that has yet to be peer reviewed shows that maybe Xetia does something after all.  Go figure.  About 10 years ago, a study showed that Xetia did not reduce the thickness of cholesterol plaques.  But what do you know, it prevents heart attacks anyway.  And that is what matters.