Friday's 5 Quotes for Primary Care 3-17-2023

Each of the quotes that follow is taken from a study reviewed on Patient Care® during the past week and was chosen for the research team’s passion about the clinical implications of their findings and for their potential impact on primary care practice.

Children and adolescents at the upper range of normal weight had a 26% higher risk of developing hypertension (HTN) than those in the lower range of normal weight, according to findings from a new Kaiser Permanente study of over 800 000 youth. “Hypertension during youth tracks into adulthood and is associated with cardiac and vascular organ damage. Since the organ damage can be irreversible, preventing hypertension in our young people is critically important…Further research is needed to evaluate the wide range of body weight considered normal in youths and the health risks associated with high normal weight.”

Black women who reported perceived interpersonal racism in employment, housing, and interactions with police had a nearly 30% higher risk of CHD than those reporting none. “Structural racism is real — on the job, in educational circumstances and in interactions with the criminal justice system,” said co-author Michelle A. Albert, MD, MPH, president of the American Heart Association. “Now we have hard data linking it to cardiovascular outcomes, which means that we as a society need to work on the things that create the barriers that perpetuate structural racism.”

Shorter primary care office visits were associated with greater likelihood of an inappropriate antibiotic prescription, coprescribing of opioids and benzodiazepines, and inappropriate prescribing for older adults than longer visits. The investigators found that visit length was significantly associated with “nearly every patient and visit characteristic” including shorter visits for non-Hispanic Black and patients from other racial and ethnic groups vs non-Hispanic White patients, and for patients with public insurance vs commercial insurance. The study findings reflect the concern that shorter visits may lead to prescribing as a "quick fix."

“Although e-cigarettes may represent harm-reduction for those transitioning from combustible cigarettes, they are not without potential negative health consequences. Perhaps most importantly, up to two-thirds of adults who use e-cigarettes report a desire or a plan to quit and report they would like to discuss e-ciagarette use with their primary care provider. Primary care represents an important point of contact for assessing adult e-cigarette use and associated health risks.”

A meta-analysis published in 2022 looked at 22 studies that included 55 million vaccinated individuals and 2.5 million COVID-infected persons. The study concluded that the risk of myocarditis was 7 times higher in COVID-infected persons than in persons who developed the inflammatory condition after COVID vaccination. Another study, performed by the CDC, found a 16-fold increased risk of myocarditis from COVID disease when compared to vaccination.