Do doctors know how to treat high blood pressure and high cholesterol?

Blood pressure and cholesterol problems affect millions. These are the bread, butter and sugary drinks of Internal Medicine and general Cardiology practice. It stands to reason then, that the treatment of these basic maladies would be well agreed upon. Guidelines and expert consensus statements would be clear and up-to-date. But this is far from reality. This recent story on theHeart.org chronicled the fact that treatment guidelines for high blood pressure and high cholesterol are a decade old. (And the last word on best practice for obesity treatment was 15 years ago.) Surely this death of clarity is worthy of comment. A baker can bake bread and a mechanic can change the oil. A medical doctor should know how to treat high blood pressure and high cholesterol. But the fact remains that we have no contemporary guidelines. Let me repeat: There is no expert consensus on how to treat blood pressure and cholesterol issues. Wow. It’s worth thinking about why and how this came to be. Perhaps recent disruptions in dogmatic medical thinking have played a role? Consider these facts: We’ve learned that treating to biomarkers (surrogate endpoints) isn’t such a good idea. Witness niacin and HDL. We’ve also learned that strict control of blood pressure may worsen outcomes in diabetics and the elderly. Another shocker is that the common practice of titration to certain cholesterol levels has a dubious evidence base. The role of exercise has only complicated matters. It’s now clear...
Source: Dr John M - Category: Cardiology Authors: Source Type: blogs