Thresholds for normal blood pressure and serum cholesterol

doi:10.1136/bmj.330.7506.1461

BMJ 2005;330:1461-1462 (25 June), doi:10.1136/bmj.330.7506.1461

Editorial

Thresholds for normal blood pressure and serum cholesterol

Lower thresholds mean that 90% of people over 50 years are identifiedas patients

The first 150 words of the full text of this article appear below.

For several years, disagreement has been growing in health servicesabout ever lower thresholds for "normal" blood pressure andserum cholesterol, the most common biological risk factors forcardiovascular disease. This was most publicly expressed in1999, when more than 800 doctors, pharmacists, and scientistsfrom 42 countries signed an open letter to the then directorgeneral Gro Harlem Brundtland, outlining fears that the WorldHealth Organization's new hypertension guidelines would resultin increased use of antihypertensive drugs, at great expenseand for little benefit.^1
2 The simplistic linear structuringof many research questions and the extrapolation of researchresults over prolonged and unstudied time periods produce guidelinesthat make many doctors, and particularly general practitioners,feel uneasy about the high proportion of their patients whoare being labelled as sick.

General practitioners are aware of the side effects of unduemedicalisation and tend to question the external validity of. . . [Full text of this article]

Steinar Westin, general practitioner and professor of social medicine

Department of Public Health and General Practice, Norwegian University of Science and Technology, Medical Technical Research Centre, N-7489 Trondheim, Norway
(steinar.westin@ntnu.no)

Iona Heath, general practitioner

Caversham Group Practice, London NW5 2UP

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