Wednesday, November 25, 2015

Some Blood Pressure Numbers To Contemplate -- Over Your Turkey, Stuffing, Gravy And Sweet Potato Pie... Not Really O/T


I won't offer a long wind up here -- just mostly point you to a terrific post over at MedNewsToday -- by Alan Cassels. [Graphic at right is his summarized fine work, as to all the content -- ours, as to the derivative styling. Click to enlarge.]

Much was made last month -- of the very large SPRINT blood pressure study results, purporting to support the thesis of "even lower" is better -- or, "ever lower" if you prefer -- for reducing cardiovascular risks. Cassels has admirably offered us the flip side -- the numbers needed to harm -- when a two-, or three-drug regimen drives those numbers down -- very, very low. Kidney problems -- up to and including renal failure -- emerge as one of those off-target effects, as providers ramp up the dosages. Do read all of his -- but these are his takeaways:

. . . .I decided to construct my own table using the individual Secondary Outcomes and Serious Adverse Effects that were found to be ‘statistically significant’ (i.e.: had a P-value lower than 0.05). As you see in the list below, here’s how many people need to be treated to be helped or harmed in the “intensive” blood pressure group compared to “standard” therapy:

125: Number needed to treat to prevent one case of heart failure.

167: Number needed to treat to prevent one death by cardiovascular causes

83: Number needed to treat to prevent death by any cause

100: Number needed to harm to cause one case of hypotension

167: Number needed to harm to cause one case of syncope

125: Number needed to harm to cause one case of electrolyte abnormality

56: Number needed to harm to cause one case of acute kidney injury or renal failure

42: Number needed to harm to cause one serious adverse event. . . .


Those rather low numbers needed to harm, at higher dosages -- should give us all pause. So -- do take the NEJM Sprint article with this in mind, as you settle into your easy chair, after that second helping of bacon-infused smoky turnip greens and buttery cornbread. I know I will. Safe and Happy Holidays, to all! I'm off. . . .

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