Medications are responsible for at least 10% of emergency hospital admissions in older people so the less taken the better
We are advised to-
Take statins - to control cholesterol
Take anti hypertensives - to control blood pressure
Take asprin to control risk of clots
Well I have already talked about statins (see previous blog)
Asprin is great at stopping clots but causes lots of bleeds - gastric bleeds and bleeds in the brain.
Anti-hypertensives (bloods pressure pills) are strong medicines which also have side effects. So who do you get to take them? According to NICE everyone with a BP over 140/90. Well I don't know about you but when I am tested (for anything) my blood pressure goes up. Being tested is terrifying whether it is on your times tables at primary school or on anatomy at medical school or by someone in a white coat at the surgery taking your blood pressure.
This is why us older doctors would not dream of taking the tablets unless it had been shown that our blood pressure was raised under normal conditions at home. Under these conditions NICE recommends 135/85 as the upper limit above which those tablets should be taken.
It is easy to check blood pressure at home. Chemists sell inexpensive home blood pressure testing stuff - very easy to use. Test yourself several times at day (at the same times) for several days and take an average reading. Most GP's are quite happy to be shown home readings. If the average is below 135/85 - no worries.
There is always the problem with the nurse and her protocol - beyond which she cannot see. You may have to battle your way past her or him.
Statisticians are terrifying people. They sit in ivory towers, where real people never go, playing around with numbers and coming out with bonkers ideas. Yes - statistically it might make sense to put everyone over 50 on the above three medicines in order to reduce cardiovascular disease in the country as a whole. But these people are not numbers, they are complex and are likely to get side effects - some very nasty and will feel awful and whose lives will be made quite miserable and who may never ever ever have been likely to suffer from cardiovascular illness anyway.
Now - here is an idea for the statisticians
Lots of people over 50 get breast cancer and prostate cancer. So - to improve the statistics - why not remove both breasts and prostates in all the over 50's in the country?
I'm always mystified as to how the "experts" come up with the various figures. Are they expecting my blood pressure at nearly 80 to be the same as, say, someone in their prime of life? How do they decide how much cholesterol or howmuch sodium one should have in ones blood? How do rhey decide someone is obese - are they comparing it with the BMI of the previous generation? It was recently admitted that the alcohol intake figures were a guess which "seemed reasonable" but was not derived on a scientific basis.
ReplyDeleteAs an engineer, I learnt that hydraulic theory says that if you reduce the pump pressure, less fluid flows, so if my blood pressure is reduced, surely less blood flows; is this a good thing? I'm a very reluctant taker of pills!
That blog was specially for you - English pensioner. It seems that there are many areas that English pensioner and Scottish pensioner agree on
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