Give Blood Pressure Drugs to All - page 3
From Medscape CME: May 28, 2009-Blood-pressure-lowering drugs should be offered to everyone, regardless of their blood pressure level, as a safeguard against coronary heart disease and stroke,... Read More
1Jun 4, '09 by GilaRRTQuote from azhiker96Absolutely, this has been my stance throughout the thread. If people would read beyond the title, they would find well written counter points. In addition, this is a meta-analysis. We are not talking about the worlds most reliable method of non-biased and controlled information gathering.Did anyone else do the whole unit? The study was from the UK. Doctors in America were generally unimpressed with it. I liked this doc's take on it.
All of you guys jumping on the do a study about compassion and side effects wangon, and all you people throwing out personal stories, please read the entire article. While you are dealing with a large group of people, the flaws of this paper are transparent and just as obvious. In fact, two physicians make compelling counter points.
5Jun 5, '09 by tencatYes, I read it, but i still think that it is unethical of the physicians who conducted the analysis to publish their 'findings' as 'fact'. I am glad that other physicians have called them on it, but the damage is done as people being people will latch on to the information in the first part of the article.
3Jun 5, '09 by marcos9999To prescribe blood pressure medication to patients who have high blood pressure is not as simple as it appears. There is a large variety of medications which act on different systems. The side effects can be overwhelming in some patients. To prescribe anti-hypertensives to everyone over a certain age appears to be silly at best and irresponsible at worst.
3Jun 5, '09 by OrcaThis goes right along with advertising prescription drugs on television. The drugs for erectile dysfunction are the most pervasive, but there are a lot of others. The only reason is to get people to push their doctors to prescribe medications that may not even help them. This is a way to create a market that really isn't there - an advertising-induced demand, if you will.
Without any studies at all, I can say without fear of contradiction that it is irresponsible to give antihypertensives to people with no indications for them. Making people nosedive into the concrete just so they can reduce their perceived risk of future cardiac problems seems pretty self-serving to me.
My wife's normal blood pressure runs about 95-100/55-60. Yes, let's give her antihypertensives. Maybe she can even stand for a few minutes without collapsing.
Is it just me, or does this sound like yet another "study" funded by a drug company?
The side effects can be overwhelming in some patients.Last edit by Orca on Jun 5, '09
1Jun 6, '09 by Teresag_CNSA couple of critiques:
There's something seriously flawed in the statistical conclusions. The article says Law & Wald found "the polypill reduced the risk of CHD by approximately 46% and of stroke by 62%" and then later states that "calcium-channel blockers...had a greater preventive effect on stroke than the other four agents (relative risk, 0.92; 95% confidence interval, 0.85 to 0.98)." The latter statement equates to a risk reduction of stroke of 15-2%, nowhere near the claimed 62%. This means that the statin, folic acid, and aspirin were really responsible for stroke risk reduction, not the antihypertensive.
Regarding meta-analysis: it is not a bad method. Done well, it is a rigorous way of combining the results of many studies to draw robust conclusions. It was done poorly by Law & Wald, who combined disparate populations and interventions (which is a major error in meta-analysis), doubtless in an effort to prove their point. (I am imagining the authors hunched over their data analysis software, trialing hundreds of combinations of studies to select the one meta-analysis that favors their conclusions.) Perhaps the most troubling fact in this whole mess of a study is that BMJ chose to publish it, despite glaring methodological flaws.
Additionally, the Medscape authors disclosed no financial conflict of interest, but the original study authors' potential conflicts of interest are huge, as mentioned after the editorial comments by other physicians. Something tells me that Law & Wald enjoy getting attention by suggesting outlandish remedies. Oh, yes, and they plan to make a whole lot of money, too.
1Jun 6, '09 by kanzi monkeyNot to go way off topic, but have you heard about the study on elevated c-reactive protein, cardiovascular risk, and prevention via a statin (Zocor, specifically)? (this sounds like it's leading into a very nerdy joke)
Since CRP is such an imprecise measurement of inflammation, it may be elevated in many people for unknown reasons. This study showed that the risk of cardiovascular disease was increased in people with an elevated CRP, even with normal lipids and no obvious cardiovascular risk factors. It ultimately suggested routine CRPs for adults, and statin for all with elevation.
It's interesting. I'm not putting an opinion out there. If anyone is interested I'll post the article in a new thread, even though it's a few months old.
Oh, and if that's already been done, I apologize
0Jun 6, '09 by lamazeteacher"you do not have to be overweight and inactive to have hbp, it can be caused by genetic predisposition." quote from fairy cari
i'm so glad that you found out that you have htn, in time to be treated effectively. i once took the b.p. of a colleague (a msw) at work, as she wanted asa for a ha (back in the '60s - not as much use of tylenol then). i insisted on taking it before giving her the asa, and read 260/180. i almost fainted, myself.
she told me that she'd had htn while pregnant 2 years ago and thought she'd left that behind her........ i insisted that she see a doctor within a half hour.
once on anti htn meds, she hated feeling lethargic, and i told her that would "wear off", but the peppy, funny person she had been was gone; and a grumpy, somewhat depressed person remained. i informed her doctor that i thought she'd go off her meds, and he reduced the dose. the initial high dose lowered her b.p. sufficiently, and she did well on the lower dose.
putting everyone on those drugs, is like giving insulin to all family members of diabetics. i remember when "insulin shock treatments" were given depressed patients, as an alternative to electro-shock treatment. it's anyone's guess what havoc that played in their pancreas(?es). it didn't work too well.....
i would love to see a law against research being done by manufacturers of any drug. they love to claim that the high cost of their drugs is caused by pricey research, but all research is funded by grants!Last edit by lamazeteacher on Jun 6, '09 : Reason: typos
0Jun 6, '09 by GilaRRTQuote from lamazeteacherThat does not make any sense. Most clinical trials are funded by drug companies. NIH grants fund smaller projects in the academic environment; however, the drug companies are paying for most of the identification, production, and testing of the latest and greatest therapies.
I would love to see a law against research being done by manufacturers of any drug. They love to claim that the high cost of their drugs is caused by pricey research, but all research is funded by grants!