The Sept. 12 front-page article “Blood pressure targets lowered” cited the results of a National Institutes of Health study declaring that people older than 50 will benefit dramatically from lowering their blood pressure below 120. The study has yet to be published, but, according to those The Post interviewed, the results are definitive and life-saving.
Do we know that? Many studies of the elderly have shown just the opposite: Aggressive blood-pressure control leads to more disease and disability. Perhaps in this study the heavily screened subjects were not representative of the population, perhaps the drugs had other positive effects other than lowering blood pressure that led to a survival advantage, perhaps the oldest patients did not achieve the same benefit.
Out of 1,000 people with aggressively treated blood pressure, how many more avoid serious health outcomes than 1,000 who have more reasonable control? The article did not say. And what side effects and long-term risks do the aggressively treated people incur, especially those who are elderly and have other illness?
Despite the giddy reaction to this study, it would be irresponsible and potentially dangerous to state that it proved anything. Only with careful inspection, and by comparing this study with others that have reached opposite conclusions, can we start to arrive at the truth: Every patient is unique, measurements are inaccurate and number-chasing with firm guidelines often causes more harm than benefit.
Andy Lazris, Ellicott City
The writer is a primary care physician.
As a physician it is frustrating to learn of supposedly major new medical findings from unpublished studies splashed across the front page of The Post. I am sure physicians’ offices will be flooded by worried patients demanding to know why their doctors have allowed their blood pressure to remain moderately higher. The answer is that recent studies have indicated that allowing mildly elevated blood pressure levels is safer for some patients, especially the frail elderly.
The bottom line is that medical knowledge is not written in stone and is often debatable — which argues strongly against the enforced use of treatment protocols and standards that Medicare and other insurance companies are now mandating to demonstrate meeting what they call quality targets.
Louis Meyers, Williston, Vt.