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Monday, August 27, 2012

Are you taking blood pressure tablets unnecessarily?

See this recent article commenting on a BMJ article about the ineffectiveness of blood pressure tablets.

Here is a quote from Professor Jerome Hoffman of UCLA and an expert in critical appraisal of medical literature, from the BMJ piece:

"We’ve long known that almost all benefit from treating severe hypertension comes with lowering BP [blood pressure] just a little. On the other hand, efforts to lower BP to ‘normal,’ typically requiring multiple drugs, are not only usually unsuccessful but produce more harm than good, since adverse effects of intensive treatment outweigh the minimal marginal benefit of a little more BP ‘control.’ Drug treatment of mild hypertension….may be of great value to drug makers, but it was almost predictable that it would provide little or no benefit for patients."

And another quote:

"David Cundiff, one of the authors of the Cochrane review has said that he “believes that the analysis should lead to dramatic changes in the way doctors treat mild hypertension, allowing patients to throw away their blood pressure pills and focus instead on far more effective as well as evidence based approaches…"

On Inside Health on Radio 4 on 21st August they too were discussing the over-diagnosis and over-treatment of high blood pressure:
"Dr Mark Porter asks whether doctors can try too hard in the early detection of disease and investigates the overdiagnosis of hypertension. This week he discovers that as many as 3 million people who have been told they have high blood pressure may not actually have it - could you be one of them?"
The programme found that there is indeed a large and growing problem of overdiagnosis and over-treatment for blood pressure. The general opinion was that it is usually better to avoid prescribing the blood pressure drugs, which of course have adverse side-effects, and instead advise patients about life-style changes that reduce high blood pressure. My own very high blood pressure years ago was dramatically and safely lowered by seriously reducing my intake of salt and salty food.