30-Second Takeaway
- New 2025 ACC/AHA hypertension guideline and ABPM guidance refine diagnosis thresholds and monitoring choices in everyday practice.
- Methadone may reduce pain-related utilization vs buprenorphine without higher overdose or mortality in Medicare patients with OUD and chronic pain.
- Apixaban offers better effectiveness, safety, and home time than warfarin, while rivaroxaban shows no clear advantage after VTE in older adults.
- Continuous monitoring reduces postoperative hypoxemia duration on wards; CGM and sustained MVPA substantially lower complications and mortality risk.
- Intensive lipid lowering benefits adults ≥65, and RAAS inhibitors may confer pancreatic cancer and mortality advantages vs calcium channel blockers.
Week ending March 28, 2026
Practice-ready updates in hypertension, cardiometabolic risk, and chronic disease management
Key practice points from the 2025 ACC/AHA hypertension guideline
This synopsis summarizes updated ACC/AHA 2025 recommendations for prevention, detection, evaluation, and management of hypertension in adults. It reinforces using standardized, accurate blood pressure measurement and greater reliance on out-of-office monitoring to confirm diagnoses. The guideline emphasizes global cardiovascular risk assessment to guide treatment thresholds and intensity. It also addresses lifestyle modification, pharmacologic treatment selection, and follow-up strategies across outpatient and inpatient settings.
When to order ambulatory blood pressure monitoring vs home BP monitoring
This Clinical Insights article clarifies indications and interpretation for ambulatory blood pressure monitoring (ABPM). It highlights scenarios where ABPM may be preferable to home blood pressure monitoring, such as suspected white coat or masked hypertension. The piece discusses integrating ABPM data into diagnosis and treatment decisions for hypertension. It provides practical guidance on threshold values and patterns that should prompt therapy initiation or adjustment.
Methadone vs buprenorphine in OUD with chronic pain among Medicare patients
This target trial emulation compared methadone and buprenorphine in 49,727 Medicare patients with opioid use disorder and chronic pain. Methadone initiation was associated with lower adjusted incidence rates of pain-related hospitalizations and emergency department visits than buprenorphine in per-protocol analyses. Rates of opioid overdose and all-cause mortality over one year did not differ meaningfully between groups. Findings suggest methadone may better reduce pain-related utilization without higher overdose or mortality risk, though unmeasured confounding remains a limitation.
Apixaban outperforms warfarin and rivaroxaban after VTE in older adults
In 18,066 Medicare beneficiaries ≥65 years with acute VTE, apixaban was compared with rivaroxaban and warfarin using propensity score weighting. Versus warfarin, apixaban reduced the 1-year composite of recurrent VTE or death and lowered major bleeding rates, with similar patterns across frailty strata. Apixaban also reduced home-time loss compared with warfarin, indicating more days alive and out of healthcare facilities. Rivaroxaban showed no clear advantage over warfarin for effectiveness or bleeding and resulted in greater home-time loss than apixaban.
References
Numbered in order of appearance. Click any reference to view details.
Additional Reads
Optional additional studies from this edition.