Identifying risks is futile without evaluations of risk reduction

doi:10.1136/bmj.311.7005.628a

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A J McCleary

Vascular research fellow Vascular Surgery Unit, General Infirmary at Leeds, Leeds LS1 3EX

EDITOR,--N Mamode and colleagues conclude that all surgeons should have a protocol for investigating patients who seem to be at risk of a myocardial infarction perioperatively.1 Even if it was possible to identify or quantify the risk accurately, however, there is little point in the exercise unless effective strategies exist for managing patients at risk. Many of the measures that can be undertaken to minimise risk--for example, control of hypertension …