News in brief - July 18, 2005

USPSTF offers new HIV screening recommendation - Blood pressure and diuretics

USPSTF offers new HIV screening recommendation

All pregnant women, not just those at risk for contracting HIV, should be screened for HIV infection, according to a new recommendation by the U.S. Preventive Services Task Force.

The updated recommendation, published in the July 5 issue of the Annals of Internal Medicine, is based on evidence that currently available tests accurately identify pregnant women who are HIV-infected and that recommended treatments can dramatically reduce the chances that an infected mother will transmit HIV to her infant, according to the task force.

The task force is an independent panel of experts in prevention and primary care supported by the federal Agency for Healthcare Research and Quality.

Recent evidence indicates that prenatal counseling and HIV testing has gained wider acceptance among pregnant women and that universal testing increases the number of women diagnosed and treated for HIV before delivery. Recommended treatment of HIV-infected pregnant women has been shown to significantly reduce the number of women who pass the virus to their newborns.

Blood pressure and diuretics

Diuretics work better than newer and more costly medicines in the treatment of hypertension and prevention of some forms of heart disease in people with type 2 diabetes, according to results from the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial, or ALLHAT.

The latest ALLHAT results were published in the June 27 Archives of Internal Medicine.

Results from an earlier ALLHAT study published in the Dec. 18, 2002, Journal of the American Medical Association found that diuretics were superior in preventing adverse cardiovascular disease outcomes compared with other first-step antihypertensive medications. The current report indicates that this is true not only in hypertensive patients with normal blood sugar but also in those with diabetes or an impaired fasting glucose.

Almost three out of every four people with type 2 diabetes has hypertension, putting them at substantial risk for cardiovascular disease, said Paul K. Whelton, MD, lead author of the study and senior vice president for health sciences at Tulane University in New Orleans. An important question in patients with type 2 diabetes and hypertension has been whether it makes a difference which medicine is used for initial therapy of high blood pressure, he said.