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Centre for Evidence-
Based Medicine

Harm: Clinical Scenario

You see a 73 year old man in your general medicine clinic who has a history of hypertension for which he has been taking nifedipine XL 30 mg PO per day for 5 years. In his retirement he has learned how to use the Internet, and he brings you a print-out of some newspaper headlines that he unearthed while surfing the net:

  • LA Times - HYPERTENSION MED KILLS
  • Washington Post - DRUG FOR BLOOD PRESSURE LINKED TO HEART ATTACKS: RESEARCHERS FEAR 6 MILLION ARE IMPERILLED

He is very worried and wants to know if he should stop taking nifedipine. Together, you form the clinical question, "In patients taking calcium antagonists for hypertension, do these calcium antagonists cause cancer?" You track down the Lancet article referred to in the scary newspaper article Lancet 1996;348:493-7.

Read the article and decide:

  1. Are the results of this harm study valid?
  2. Are the results of this harm study important?
  3. Should these valid, important results of this study about a potentially harmful treatment change the treatment of your patient?

Continue to completed worksheet