Modern medicine is witnessing unprecedented acceleration in the production of scientific evidence and clinical studies, making it difficult for health practitioners to keep up with the vast amount of new knowledge and evaluate which of it deserves to actually reflect on daily practice. Among the thousands of studies published annually, only a limited number succeed in bringing about real change in diagnostic, therapeutic, and preventive methods. Hence, the importance of reviewing this scientific evidence with a critical eye that combines clinical expertise and a deep understanding of medical research methodology emerges, aiming to translate scientific results into practical messages that benefit both doctors and patients.

Dr. Hassan Shamsi Pasha

In this context, the 'Health' supplement hosted Dr. Hassan Shamsi Pasha, consultant cardiologist at the European Medical Center in Jeddah, and one of those interested in following global scientific developments and analyzing their implications for clinical practice. We review with Dr. Pasha the most prominent studies that caught the attention of the medical community during 2025, which a number of experts believe may contribute to reshaping some established therapeutic concepts and open new horizons for primary care physicians and various specialties.

Dr. Pasha explained that the medical world annually witnesses the publication of thousands of studies and research, but only a few succeed in changing daily clinical practice. Family and primary care physicians face a continuous and massive influx of medical research, posing a real challenge in identifying the most robust scientific evidence to apply in daily practice.

In this context, the Canadian research team (PEER) - a specialized research group in evidence-based medicine - reviewed and classified the most influential controlled studies (RCTs) and systematic reviews published in 2025 across major international medical journals (such as 'The Lancet', 'NEJM', and 'The BMJ'). The team's research was published in the 'Canadian Family Physician' journal in May 2026.

A multidisciplinary team including family doctors, pharmacists, and nurses participated in evaluating and constructing this evidence to ensure accurate statistical summaries relevant to daily clinical practice. Below are the most important findings that every doctor and patient should know.

Medication Timing and Efficacy Comparison

• First: Timing of blood pressure medication: morning or evening? For years, the prevailing belief was that taking blood pressure medication in the evening might reduce the risk of heart attacks and strokes. However, a large randomized study involving more than 3,300 patients with hypertension followed for 4.6 years showed that taking the medication at night did not reduce rates of death, heart attacks, or strokes compared to taking it in the morning. Although nighttime blood pressure was slightly lower in the evening group... this did not translate into important clinical outcomes.

- Conclusion: Taking blood pressure medication at bedtime is completely safe, but it does not provide additional reduction in cardiovascular events compared to morning doses. Therefore, medication scheduling should be based on the patient's desire and personal preference to ensure adherence.

• Second: Tirzepatide outperforms Semaglutide in weight loss. The year 2025 witnessed one of the most important studies in obesity treatment, comparing Tirzepatide and Semaglutide in non-diabetic obese patients. After 72 weeks of treatment, users of Tirzepatide lost 20.2% of their weight, while patients on Semaglutide lost 13.7% of their weight. Additionally, 82% of Tirzepatide users achieved weight loss exceeding 10% of body weight compared to only 61% with Semaglutide.

- Conclusion: Tirzepatide has become the most effective weight loss treatment among currently available drug therapies.

• Third: Are beta-blockers still necessary after myocardial infarction? For decades, beta-blockers were considered a cornerstone after myocardial infarction, but recent studies have reconsidered this concept. Clinical analyses in 2025 showed that patients with an ejection fraction (systolic function of the heart) between 40–49% benefited from beta-blocker therapy. However, patients with an ejection fraction of 50% or more (i.e., acceptable heart function) did not achieve any significant benefit from continuing them.

- Conclusion: Routine use of beta-blockers after infarction is no longer justified in patients with normal ventricular function.

Treatments and Measurements

• Fourth: Treating the partner of a woman with bacterial vaginosis. An Australian study showed that treating the husband or male partner with antibiotics concurrently with the woman's treatment reduced the recurrence rate from 63% to 35%.

- Conclusion: Treating the husband along with his infected wife is clinically effective, which explains why this study surpasses previous historical research. Treating the partner may become part of the future treatment strategy for recurrent cases.

• Fifth: When can a wound be washed after surgery? Surgeons have traditionally advised patients to keep wounds dry for at least 48 hours. However, a recent study showed that exposing the wound to water just 6 hours after surgery did not increase rates of inflammation, bleeding, or poor wound healing compared to waiting 48 hours. However, the study included only 24% of its proposed sample, which reduces its absolute statistical power.

- Conclusion: Early showering may be allowed in some minor skin surgeries, but it is necessary to consult the doctor, as he knows the condition best.

• Sixth: A common mistake when measuring blood pressure. Studies have shown that incorrect arm positioning leads to falsely elevated readings. Placing the arm on the thigh raises the blood pressure reading by about 4 mmHg, and leaving the arm hanging unsupported raises it by up to 6 mmHg. Ambient noise had no significant effect.

- Conclusion: The arm should be supported and at heart level during measurement. Strict adherence to correct arm positioning—fully resting the arm on a flat table with the midpoint of the cuff exactly at heart level—is essential to prevent false elevation of pressure.

• Seventh: Mirtazapine for insomnia in the elderly. Mirtazapine improved sleep in elderly patients with chronic insomnia compared to placebo. However, the benefit came at the cost of increased side effects such as daytime drowsiness, mental confusion, and fatigue. The rate of discontinuation due to side effects (such as cognitive lethargy and severe daytime sleepiness) was 22% compared to 3% in the placebo group.

- Conclusion: Mirtazapine improves chronic insomnia in the elderly at low doses, but it carries a heavy burden with high rates of significant side effects and early discontinuation.