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In their editorial, William Ghali and Nicholas Rodondi point out that
treatments that modify a disease risk marker do not necessarily modify the
risk.
Hypertension is a risk marker that is easier to measure than HDL
Cholesterol and has been used as a marker of CVD for much longer. Trials
have shown that different drugs that modify the risk marker of BP equally
are not equal in their effect on long-term morbidity from CVD. Also,
trials of anti-hypertenive agents that report a significant reduction in
CVD end-points do not show substantial drops in BP. This leads me to
surmise that we should be choosing anti-hypertensive drugs and dosages by
their effect on end-points rather than the current accepted practice of
treating the risk marker of BP to a set target regardless of which drug we
use.
Treating disease markers
In their editorial, William Ghali and Nicholas Rodondi point out that
treatments that modify a disease risk marker do not necessarily modify the
risk.
Hypertension is a risk marker that is easier to measure than HDL
Cholesterol and has been used as a marker of CVD for much longer. Trials
have shown that different drugs that modify the risk marker of BP equally
are not equal in their effect on long-term morbidity from CVD. Also,
trials of anti-hypertenive agents that report a significant reduction in
CVD end-points do not show substantial drops in BP. This leads me to
surmise that we should be choosing anti-hypertensive drugs and dosages by
their effect on end-points rather than the current accepted practice of
treating the risk marker of BP to a set target regardless of which drug we
use.
Competing interests:
None declared
Competing interests: No competing interests