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BMJ 2004;329:570 (4 September), doi:10.1136/bmj.329.7465.570-a
| The first 150 words of the full text of this article appear below. |
EDITORThe new guidelines from the British Hypertension Society exemplify the best and the worst features of current medical thought processes.1 2 They exemplify the best in collating evidence from many trials and transforming it into a clear and useful form. They define the problem clearly and positively guide us as doctors, and patients, on future treatment of the defined problem.
Yet they miss some important wider issues. Maybe the omission is deliberate, or maybe the authors are not fully aware of these problems. From a secondary care perspective, seeing patients in admissions wards with strokes due to hypertension, to reduce blood pressure in everyone with hypertension seems to make sense. Yet when viewed from a primary care or public health viewpoint, such a view is far from proved.3
The hypertension guidelines give no information on numbers needed to treat to achieve a reduction in cardiovascular events. Yet the numbers
Peter Davies, general practitioner
Mixenden Stones Surgery, Halifax HX2 8RQ npgdavies@blueyonder.co.uk