Modern medicine is witnessing an unprecedented acceleration in the production of scientific evidence and clinical studies, making it difficult for healthcare practitioners to keep up with the vast amount of new knowledge and assess what truly deserves to be reflected in daily practice. Among the thousands of studies published annually, only a limited number succeed in making a real change in diagnostic, treatment, and prevention methods. Hence, the importance of reviewing this scientific evidence with a critical eye that combines clinical expertise and deep understanding of medical research methodology, aiming to translate scientific results into practical messages that benefit both doctors and patients.

Dr. Hassan Shamsi Pasha

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

A multidisciplinary team including family physicians, pharmacists, and nurses participated in evaluating and constructing this evidence to ensure the provision of 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 medications: morning or evening? For years, the prevailing belief was that taking blood pressure medications in the evening might reduce the risk of heart attacks and strokes. However, a large randomized study involving more than 3,300 hypertensive patients followed for 4.6 years showed that taking the medication at night did not lead to reductions in mortality, heart attacks, or strokes compared to morning administration. Although nighttime blood pressure was slightly lower in the evening group, this did not translate into significant clinical outcomes.

- Bottom line: Taking blood pressure medication at bedtime is completely safe, but it does not provide additional reduction in cardiovascular events compared to morning doses. Accordingly, medication scheduling should be based on patient preference to ensure adherence.

• Second: Tirzepatide outperforms semaglutide in weight loss. The year 2025 saw one of the most important studies in obesity treatment, comparing tirzepatide and semaglutide in obese patients without diabetes. After 72 weeks of treatment, tirzepatide users lost 20.2% of their weight, while semaglutide patients lost 13.7%. Also, 82% of tirzepatide users achieved weight loss exceeding 10% of body weight, compared to only 61% with semaglutide.

- Bottom line: Tirzepatide has become the most effective weight loss drug among currently available pharmacological treatments.

• 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 from 2025 showed that patients with ejection fraction (systolic function) between 40–49% benefited from beta-blocker therapy. However, patients with ejection fraction of 50% or more (i.e., acceptable cardiac function) derived no significant benefit from continuing them.

- Bottom line: 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 reduced the recurrence rate from 63% to 35%.

- Bottom line: Treating the husband along with his infected wife is clinically effective, which explains why this study surpasses previous historical research. Partner treatment may become part of future therapeutic strategies 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, but 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, reducing its absolute statistical power.

- Bottom line: Early showering may be allowed in some minor skin surgeries, but it is necessary to consult a doctor, as they are more knowledgeable about the condition.

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

- Bottom line: The arm should be supported at heart level during measurement. Strict adherence to correct arm positioning—resting the entire 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 older adults. Mirtazapine improved sleep in older adults with chronic insomnia compared to placebo. However, the benefit came at the cost of increased side effects such as daytime drowsiness, confusion, and fatigue. The discontinuation rate due to side effects (e.g., cognitive lethargy, severe daytime drowsiness) was 22% compared to 3% with placebo.

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