E-drug: E-DRUG: HOT: can we turn WHO around? (2)
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dear E-druggers,
Anybody else troubled about these sort of attitude toward treatment of
hypertension? A similar stance is that of this whole idea of "white coat
hypertension". Heart attacks and strokes are # 1 and 2 in premature
morbidity and mortality and CHF is number one in medicare expenditure,
and yet all are potentially preventable. It seems we come up with more
excuses not to treat, or not to treat aggressively enough, and then shrug
when the patient ends up dying or in a nursing home or at minimum suffers
a worsening in quality of life. It is a very important finding that
there was no increased mortality with further lowering of blood
pressure. Of course more aggressive treatment may mean more expense for
drugs, but not necessarily so. More aggressive life style modifications
can be used. There are also a few companies that don't increase the cost
with increases in milligram strength of their drugs. But you won't think
of implementing these messures if your goal is to just treat "to
somewhere around 140/90".
Robert Marshall, MD
Email: marshalr@OHSU.EDU
[next time, please add your affiliation - thanks! Wilbert Bannenberg,
co-moderator E-drug]
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