Intended for healthcare professionals

Editorials

Thresholds for normal blood pressure and serum cholesterol

BMJ 2005; 330 doi: https://doi.org/10.1136/bmj.330.7506.1461 (Published 23 June 2005) Cite this as: BMJ 2005;330:1461

A timely warning

The authors must be commended on their timely paper. It is
inconceivable that 90% of any population can be considered ill enough to
be placed on drugs for the rest of their lives. This is the antithesis of
medicine and the adage 'first do no harm.'

By placing untold millions of people on drugs we are quite definately
doing harm. Are we doing any good?

The only studies on statins that have shown reduction in overall
mortality are the secondary prevention studies such as 4S and HPS. Even in
these studies there was no reduction in overall mortality in women. A
result dismissed as a statistical aberration.

Furthermore, in none of the primary prevention studies on statins has
there been any reduction in overall mortality in men, or women.

In short, for all women, and the vast majority of men, taking a
statin may alter what is written on a death certificate, but it will not
change the date.

With regard to blood pressure lowering, there have been ninteen major
trials comparing active compound to placebo. In total, this represents
67,768 years of treatment. At the end of all trials 150 more patients on
antihypertensives were alive, than in the placebo group. Each patient
gaining, on average, six months of extra life.

This adds up to a grand total of 75 extra life years gained from
67,758 years of treatment. If this figure is extrapolated, the results of
the antihypertensive trials mean that if you take a blood pressure
lowering tablet for thirty years, you may expect to live for 12 more days.
About the time taken to swallow the tablets, probably.

Advising millions of people to take drugs for such minuscule gain,
and huge societal and economic costs, is medical madness at the very
extreme boundaries of human behaviour.

Competing interests:
A member of the International Network of Cholesterol Skeptics (www.thincs.org)

Competing interests: No competing interests

25 June 2005
Malcolm e Kendrick
Medical Director Adelphi Lifelong Learning
Adelphi Lifelong Learning, Adelphi Mill Bollington SK10 5JB