DietSpotlight.com
Is all that intensive drug treatment worthwhile?A paper published in 2006 demonstrated that laboratory findings do not constitute disease. And altering measurements such as blood pressure or cholesterol if you are elderly show little or no benefit (despite what the pharmaceutical industry and many doctors would have us believe). One thing that seems to be forgotten is that we are not an immortal species; we all have to die eventually and if one thing doesn't get us, something else will. That is why it is so important, when evaluating treatments, not just to consider deaths due to the disorder being treated, but also to look at deaths from all causes. This is frequently not done - particularly in papers about diseases of the heart. The Finnish researchers enrolled 400 home-dwelling people between the ages of 75 years and 90 years with CVD. These people were randomly selected from the population living in Helsinki and randomly assigned, using concealed allocation, to receive either usual care from their primary care physician or to receive specialized care based on current evidence-based European guidelines for chronic cardiovascular disease (CVD). The strength of this study is that the researchers randomly invited patients from the general population to participate, making the results applicable to typical primary care. The interventions included stopping smoking, changing their diets, being medicated for high blood pressure and cholesterol, taking beta-blockers following a heart attack, angiotensin-converting enzyme (ACE) inhibitors for heart failure, anticoagulant drugs in selected patients and aspirin. Over an average 3.4 years, beta-blocker, ACE inhibitor, diuretic, and statin use was significantly higher in the intervention group. Was there any benefit? No! Blood pressure and cholesterol control were significantly better in the intervention group. However, patient-oriented outcomes, which were common, were not improved.
In other words, all that time spent by doctors, the inconvenience to patients of having tests, the drugs used and money spent, the side effects that the intervention group inevitably had to endure from the drugs they were prescribed, as well as the inconvenience of having to give up pleasures such as smoking and eating an enjoyable diet, probably made their quality of life worse without adding so much as a day to their life-expectancy. The study and abstract is below.
Last updated 17 May 2009 |
