Vitamins and Minerals for Blood Pressure Reduction in the General, Normotensive Population: A Systematic Review and Meta-Analysis of Six Supplements.

Hypertension is the leading preventable risk factor for cardiovascular disease and all-cause mortality worldwide. However, studies have shown increased risk of mortality from heart disease and stroke even within the normal blood pressure (BP) range, starting at BPs above 110-115/70-75 mm Hg. Nutraceuticals, such as vitamins and minerals, have been studied extensively for their efficacy in lowering BP and may be of benefit to the general, normotensive population in achieving optimal BP. Our study investigated the effects of six nutraceuticals (Vitamins: C, D, E; Minerals: Calcium, Magnesium, Potassium) on both systolic blood pressure (SBP) and diastolic blood pressure (DBP) in this population. We performed a systematic review and pairwise meta-analysis for all six supplements versus placebo. Calcium and magnesium achieved significant reductions in both SBP and DBP of -1.37/-1.63 mm Hg and -2.79/-1.56 mm Hg, respectively. Vitamin E and potassium only yielded significant reductions in SBP with values of -1.76 mm Hg and -2.10 mm Hg, respectively. Vitamins C and D were not found to significantly lower either SBP or DBP. Future studies should determine optimal dosage and treatment length for these supplements in the general, normotensive population.

Where are the rest of us? Improving representation of minority faculty in academic medicine.

OBJECTIVES: Low numbers of underrepresented minority faculty members in academic medicine (black, Hispanic, Asian/Pacific Islander, Native American/Alaskan) continue to be a concern for medical schools because there is higher attrition and talent loss among this group. Although much has been written on this topic, there has not been a systematic review of the indexed literature published. METHODS: We searched MEDLINE, Web of Knowledge, ProQuest, and Google Scholar for articles relating to minority faculty and identified relevant articles. We then graded the evidence using the Strength of Recommendation Taxonomy. The same criteria were applied to extract evidence-based observations of challenges faced by minority faculty and provide recommendations. RESULTS: Of the 548 studies identified and reviewed, 15 met inclusion criteria for this literature review. Of the 15, 9 were cross-sectional studies and 6 were analyses of existing Association of American Medical Colleges workforce data. The cross-sectional studies documented perceived bias in the recruitment of faculty, quantified the lack of minority mentors, and revealed that black and Hispanic faculty members are more prevalent in states with higher minority populations. Studies using the Association of American Medical College workforce data also documented evidence of promotion bias, the lack of diversity in academic plastic surgery, and the lack of minority researchers funded by the National Cancer Institute. CONCLUSIONS: This systematic review provides evidence that racism, promotion disparities, funding disparities, lack of mentorship, and diversity pressures exist and affect minority faculty in academic medicine. Based on these observed challenges, this review also provides specific recommendations that could improve representation of minority faculty members in academic medicine. These recommendations include implementing proven pipeline programs to increase the number of minority medical students, a systemwide adoption of proven culture change initiatives, reexamination of assignments to ensure equitable time distribution, and a reduction of medical school debt.