My personal opinion about the new blood pressure and cholesterol guidelines

I admit that I am a very opinionated person but I have been restraining myself in the last few posts. I have written three posts on the new cholesterol guidelines and one on the new blood pressure guideline. In those, I tried to simply translate the medical jargon and summarize the key points in an … Read more My personal opinion about the new blood pressure and cholesterol guidelines

New high blood pressure treatment guidelines: a simple look at the actual evidence based recommendations

blood pressure numbers chart.001It is important to note that there are two distinct classes of recommendations in the new American guidelines for treatment of high blood pressure: evidence based and opinion based. The evidence based guidelines for treatment of high blood pressure are based on factual data. In other words, these are strong recommendations that carry the weight of concrete evidence that came out of a large number of medical trials. The opinion based guidelines, on the other hand, do not have direct evidence to back up the recommendations. They are mostly based on the opinion of the doctors working to develop the guidelines.

I will only be stating the evidence based guideline because this is what really counts. Different doctors may treat high blood pressure differently but you need to know what the evidence from latest medical research suggests. In the end, the actual decision about how to treat your high blood pressure should be between you and your doctor.

Read moreNew high blood pressure treatment guidelines: a simple look at the actual evidence based recommendations

The best thing about the new cholesterol guideline is not about cholesterol, it is about you

cholesterol levels no heart attack.001In the history of cholesterol guidelines, the new 2013 cholesterol guideline is the only one that puts the decision to treat high cholesterol for prevention of heart attack and strokes in the hands of the patients.

This part of the cholesterol guideline is not about your cholesterol levels but it is about you. This applies to you only if you have not had any heart attacks or strokes in the past. If your had heart attacks or strokes, you need the cholesterol medicine. They strongly recommend it regardless of your cholesterol levels.

This particular point in the guideline includes majority of patients that are unnecessarily worried about their cholesterol levels. The following example will illustrate my point.

Read moreThe best thing about the new cholesterol guideline is not about cholesterol, it is about you

Cholesterol levels do not affect the need for cholesterol medications when you have a history of heart attack or stroke, new guideline says

Cholesterol levels with heart attack and strokeWe have been talking about cholesterol levels and talking specific numbers and target goals for years. People have been asking about normal cholesterol levels, low cholesterol levels, high cholesterol levels, good cholesterol levels and bad cholesterol levels for years. However, the recent cholesterol guidelines have clearly stated that it does not matter what your cholesterol levels are, you need treatment with a specific type of cholesterol medications called statins if you fall into certain risk category for heart attacks and strokes.

The one group of patients they unequivocally and strongly recumbent starting cholesterol medication is the group of patients under 75 years of age who have had heart attacks or strokes in the past.

Read moreCholesterol levels do not affect the need for cholesterol medications when you have a history of heart attack or stroke, new guideline says

New Cholesterol Guidelines: A simplified translation for patients

2013 new cholesterol guidelinesSix new items in the new cholesterol guideline:

The new cholesterol guideline clearly states that it has the following six new items that deviate from old guidelines. This is not the actual guideline but is more like the guiding principles. I will summarize the actual cholesterol guidelines after listing these items.

1. Focus on prevention of heart attacks and strokes:

The new guideline puts cholesterol in the context of all other risk factors and moves away from treating the numbers per se.

2. Less emphasis on actual reduction in cholesterol levels:

The new goal of treatment is to reduce risk of heart attacks and strokes. They no longer emphasize the goal of reducing cholesterol to a target level.

Read moreNew Cholesterol Guidelines: A simplified translation for patients

Chest pain: What patients need to know

Chest pain is probably the most common, most dangerous, most expensive and most worrisome of all medical symptoms. I believe all patients need to know these ten things about chest pain: 1. Chest pain means heart attack unless proven otherwise: This is how the system to evaluate chest pain is designed. It does not mean … Read more Chest pain: What patients need to know

“Why am I being admitted to the hospital?” the answers may surprise you

5 reasons they hospitalize you when you don't need itMedical technology is advanced and scientific but medical practice is really subjective and primitive. You may be surprised to know that a significant proportion of medical decisions are made with a high degree of uncertainty and ambiguity. 

The decision to admit you to the hospital when you visit an emergency department is one of the most subjective medical decisions an ER doctor has to make everyday. There are situations when you would be admitted to the hospital no matter which ER doctor happens to see you, and there are situations when you would not be admitted to the hospital in any case. But, many situations fall in between the two extremes.

Read more“Why am I being admitted to the hospital?” the answers may surprise you