Oh Bull****
The Market Ticker - Commentary on The Capital Markets
2017-11-14 13:54 by Karl Denninger
in Personal Health , 450 references Ignore this thread
Oh Bull****
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Here we go again...

Americans with blood pressure of 130/80 or higher should be treated, down from the previous trigger of 140/90, according to new guidelines announced on Monday by the American Heart Association and the American College of Cardiology.

Note that this is an or.

This of course means that the doctor cabal gets to brand medical charts (yes, exactly like a car title) on a whim.

Let me explain.

There are myriad things that influence blood pressure.  It typically varies by anywhere from 10 to 20 points in most people over relatively short periods of time.  A cup of coffee will frequently raise it by 10pts -- for a couple hours.

This is not dangerous, but it is sufficient to put you over the "80" threshold and get your chart branded!

140/90 was sufficiently clear of this that transient causes were unlikely to result in you being tagged if you weren't really in trouble.  130/80 where it's an "or", not an and, is not and will result in millions of people being prescribed drugs that are dangerous -- without cause.

Potentially deadly high blood pressure can be brought under control with a wide array of medications, many sold as relatively inexpensive generics. The drug classes include angiotensin receptor blockers, such as Novartis AG’s Diovan, calcium channel blockers, like Pfizer Incs’s Norvasc, ACE inhibitors, including Pfizer’s Altace, and diuretics, such as Merck & Co Inc’s Hyzaar.

All drugs have side effects.  There are quite serious side effects associated with most of these.  That's not to say they don't have a use and proper purpose in the medicine cabinet -- they do.

But prescribing them to people who have quite-possibly transient elevations in blood pressure that are not dangerous in any meaningful way is an outrage.  As noted most of these are available cheaply, but even the "cheap" generics have a cost and the side effects are real.

What are some of those problems?  Fainting (gee, that would be a nice way to whack your head, right?) and kidney issues.  Kidney problems are especially nasty in that they can lead to renal failure which means you get to live on dialysis at ruinous cost -- and then almost-inevitably die miserably.

I also question this claim:

Adults with blood pressure of 130/80 “already have double the risk of heart attack compared to someone in the normal range,” said Dr. Paul Whelton, professor at Tulane University School of Public Health and Tropical Medicine and School of Medicine in New Orleans and lead author of the new guidelines. 

Prove it.  I've looked for the alleged evidence and thus far haven't found it.

If you've got it, let's see it.

Let me be more-specific on what I expect you can prove.

High blood pressure tends to be associated with obesity, inactivity, smoking and excessive alcohol use (for starters.)  All four of those are known causes of heart attacks and strokes.  To make the argument that 10 points in systolic blood pressure (e.g. 130/80 .vs. 120/80) results in a doubling of heart attack risk you must show that the blood pressure difference, and only the blood pressure difference, results in the increase in risk.

In other words you need as your "control" group people who are exactly as fat (or not), exactly as inactive (or not), who do the same amount of smoking (or not) and who consume the same amount of alcohol (or not.)

Otherwise what you're seeing is the symptom of the cause rather than the cause itself, and thus if someone presents with a 130/80 blood pressure, is not obese, does not smoke, is not inactive and does not drink to excess you're going to both brand their chart and prescribe a dangerous drug to them that results in no meaningful change in their heart attack risk and thus increases their morbidity and mortality rather than decreasing it.

Let us not forget that doctors and their lobbies have done this before.  For more than 40 years they peddled the lie that saturated (animal) fat was the cause of heart attacks, strokes and obesity.  They did so despite the fact that the ramp in the first two began 20 years after the rate of smoking went up by more than a factor of ten on a per-capita basis along with intentionally ignoring evidence contrary to their claims (such as those eating a Mediterranean diet, the Inuit and other populations.)  In addition it was a known fact since animal husbandry has existed that one feeds animals high carbohydrate diets to intentionally fatten them; both cattle and pork are "finished" on same prior to being slaughtered.

The result of telling us to eat large amounts of carbohydrate and unsaturated machine-processed vegetable fats was more obesity and Type II diabetes, from which the medical system as a whole has profited mightily -- instead of their claim that we would experience less disease.  Not one person has been prosecuted or otherwise held to account for this intentional lie and the harm, both in human misery and death, directly caused by same.

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