3 March 2011
Read all about it!
“Don’t believe everything you read about…”
“If it’s in the Daily Blurb, it must be right”
Yes, it’s blood pressure time again, and what confusing messages the press give to Jo Public. It doesn’t help when even so-called experts can’t agree on what constitutes hypertension.
What about “white-coat hypertension”? What about ambulatory (24 hour) blood pressure recording?
Are there any bottom lines ?
Well, just a few, my lord (as Horace Rumpole would say):
- Everyone would agree that a blood pressure above 140/90 requires treating (some say even lower).
- Most people agree that high readings at any time are significant.
- If it’s not going to affect your management, don’t do it. For instance a 24-hour blood pressure is great to get an overview of what’s happening but why do it if you’re going to treat the blood pressure anyway.
Let’s move on to treatment.
A recent article claimed that many people who had hypertension didn’t have hypertension, if you see what we mean. It went on to say that many of these supposedly normo-tensive people were being treated with antihypertensive drugs such as beta-blockers or ACE inhibitors.
Excuse me! Beta blockers? People with uncomplicated hypertension have not been (or should not have been) teated with beta blockers for five years! Ever since the ASCOT Trial sent so many sacred cows into the bull ring: increased cardiovascular events, increased diabetes.
Even ACE inhibitors are being superceded by angiotensin-2 receptor blockers.
One of the good things about a course delivered by the Primary Care Training Centre is that you get a simple message, based on the best available evidence which has been considered carefully by experts in their field.