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Aggressive blood pressure control: Too much
of a good thing?(English German)
Aggressive control from blood pressure hat saved millions from lives und hat
prevented millions from people aus experiencing heart attacks, strokes, und
kidney failure, among other things. Admittedly, controlling blood pressure ist nicht
die sexy part from medical care, aber wenn primary care doctors als mir help people
get ihre blood pressure under control, wir machen nur als much gut als any from
our colleagues wer practice als cardiovascular surgeons. (Nein offense zu those
surgeons, from course, wer machen worlds from gut für ihre patients!)Aber blood pressure reduction kann sein too much from ein gut thing. Für example, wenn patients mit diabetes receive overly aggressive blood pressure treatment, die harms from dass treatment — die side effects from low blood pressure — loom larger than die potential benefits.
Und ICH’m nicht talking nur side effects als feeling ein little bit fatigued aus taking die pill. Aggressive blood pressure treatment kann increase die risk from hazardous falls, für example. Consequently, physicians sometimes need zu take ihre foot off die gas und reduce die intensity from patients’ blood pressure medications.
Unfortunately, ein study aus JAMA Internal Medicine shows dass doctors frequently haben difficulty backing off. Die study looked beim diabetes patients und assessed whether doctors reduced die intensity from hypertension treatments wenn people’s blood pressure dropped below recognized thresholds. Sie auch looked beim whether doctors reduced die intensity from patients’ diabetes medications wenn ihre blood sugar levels — ihre A1C results — got worrisomely low. In looking beim wie aggressively doctors treated patients, die researchers auch estimated wie long patients hatte zu leben, based auf ihre age und wie sick sie were. Sie estimated this weil someone in die last, sagen, five years from his leben ist nicht going zu get much benefit aus aggressive blood pressure oder diabetes control, weil from die benefits from such control (versus mehr moderate control) accrue over many years, while die harms, die side effects, happen much mehr quickly.
Study German easily by learning how to pronounce some common words and phrases in the German Language.
Physicians were ein little better beim backing off auf aggressive diabetes treatment, aber noch backed off nur 1/3 from die time für patients mit sehr low blood sugars (A1C less than 6), even among patients expected zu leben less than five years:
Wir alle need zu remember dass too much medical care ist ein bad thing. Wenn health care interventions work, sie sometimes work too gut. Wir haben zu wissen wenn zu start people auf medications, und wenn zu take ihnen off.
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