New Medical Recommendations.

Recommendations change as new data emerges. Here are some of the new recommendations made over the last year which doctors should consider and patients may want to note.

NO LONGER RECOMMENDED:

• High dose vitamin E (400IU/day or more).
• Low dose aspirin therapy to prevent heart disease in healthy women.
• Biphosphonates to prevent fractures in women with osteopenia. Osteopenia is bone loss which has not yet reached the level of osteoporosis. On a bone desity test, osteopenia is defined as a T-score between -1.5 and 2.4. Osteoporosis is defined as a score of -2.5 or greater. Biphosphonates are still recommended for osteoprosis. Examples of biphosphantes are Fosamax (alendronate), Actonel (risedronate), and Boniva (ibandronate).
• Beta blockers as first line treatments in patients with uncomplicated high blood pressure. Some beta blockers include medications such as Atenolol and Tenormin.

NOW RECOMMENDED:

• Vitamin D 800 IU per day plus calcium supplements for women at high risk for fracture.
• Zostavax varicella zoser virus (shingles) vaccine when available to immunocompetent patients who are 60 years or older.
• Ultrasound screening for abdominal aortic aneurysm in men 65 to 73 years old who are smokers or who have other risk factors.
• Routine HIV testing.

Human papilloma virus vaccine will be addressed in a separate blog in more detail.

References: Annals of Internal Medicine, July 4, 2006. See links for specific references for each recommendation.