Loosening the definition of Hypertension
It would appear that some prominent pharmaceutical companies are pushing to have the accepted standard of hypertension diagnosis loosened to include a new cohort of prospective patients.
http://www.nytimes.com/2006/05/20/business/20hyper.html?_r=1&oref=slogin
It should be noted, that this same concept was pushed in the early 1980s. When the Surgeon General gave a speech announcing that 180 mg per dL of lipoproteins would be the low end of range cut for coronary heart disease diagnosis (down from a 200+ mg per dL) an enormous overnight jump in positive diagnoses for the disease occurred.
Now, I’m not debating the importance of coronary heart disease as a health issue. Coronary heart disease is the number one killer in the Western world. Over 59 million Americans have been diagnosed and it causes 1 in every 2.4 deaths in the U.S. (American Heart Association web site). These people also represent a big market to pharmaceutical companies. Pfizer’s Lipitor, a medication to control blood pressure, has the highest sales of any prescription medicine worldwide. A drop in the standard for a diagnosis of hypertension from 140/90 to within the range of 120/80 – 139/89 stands to instantly change the diagnosis of another 59 million Americans from reasonably healthy to people who may in the market for this sort of medication.
The question here, really, is ‘is this change valid”? Where are the long-term health studies that back the position taken by the American Society for Hypertension? Do the findings of long-term cohort projects like the Athersclerosis Risk in Communities Study (http://www.cscc.unc.edu/ARIC/#) support the suggestions of these companies? It’s common for a healthy person to sit 20 mmHg systolic over their normal blood pressure reading due to dehydration. Shouldn’t the standards of diagnosis for the deadliest disease in the Western world be set by people who are not on the dime of pharmaceutical companies?
http://www.nytimes.com/2006/05/20/business/20hyper.html?_r=1&oref=slogin
It should be noted, that this same concept was pushed in the early 1980s. When the Surgeon General gave a speech announcing that 180 mg per dL of lipoproteins would be the low end of range cut for coronary heart disease diagnosis (down from a 200+ mg per dL) an enormous overnight jump in positive diagnoses for the disease occurred.
Now, I’m not debating the importance of coronary heart disease as a health issue. Coronary heart disease is the number one killer in the Western world. Over 59 million Americans have been diagnosed and it causes 1 in every 2.4 deaths in the U.S. (American Heart Association web site). These people also represent a big market to pharmaceutical companies. Pfizer’s Lipitor, a medication to control blood pressure, has the highest sales of any prescription medicine worldwide. A drop in the standard for a diagnosis of hypertension from 140/90 to within the range of 120/80 – 139/89 stands to instantly change the diagnosis of another 59 million Americans from reasonably healthy to people who may in the market for this sort of medication.
The question here, really, is ‘is this change valid”? Where are the long-term health studies that back the position taken by the American Society for Hypertension? Do the findings of long-term cohort projects like the Athersclerosis Risk in Communities Study (http://www.cscc.unc.edu/ARIC/#) support the suggestions of these companies? It’s common for a healthy person to sit 20 mmHg systolic over their normal blood pressure reading due to dehydration. Shouldn’t the standards of diagnosis for the deadliest disease in the Western world be set by people who are not on the dime of pharmaceutical companies?
posted by Anthropolochic at 11:26 AM
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