Off-the-cuff remarks substantiated

I have ‘bumped into’ WDDTY many times on the desks of fellow professionals, and I was always impressed by the good sense and advice it contained. I have now become a subscriber myself and have received some back issues, but I feel disappointed by what I see as your double standards.

In July 1998 (WDDTY, vol 9 no 4), you printed The Ten Useless Medical Tests and, at the top of your list was blood pressure testing. Yet, in the November 2001 issue (WDDTY, vol 12 no 8), in your reply to the lady who experienced a TIA [transient ischaemic attack], you advised her that she needs to get her blood pressure checked! Now, come on, are you really suggesting that someone should have a useless test!

In my opinion, blood pressure tests should not be rubbished. In the hands of a skilled medic/nurse, it is an invaluable tool for diagnosis. But, of course, it can only be useful in the right hands. If a patient is commenced on medication, say, due to one high reading, then the doctor is at fault, not the procedure.

Patients can have 25-hour readings while they go about their daily routine. Sometimes patients are advised to see the practice nurse, as they tend to affect blood pressure less than a doctor. After an RTA, a very low blood pressure can alert a paramedic to internal injuries or shock, of which they may not otherwise have been aware. (I did say alert, not confirm).

One blood pressure reading cannot stand alone to tell the full story. But please think of the people who may have read your ‘Useless’ list and decided not to have their blood pressure checked at all – they may be having TIAs now or something even worse. – Angela Jobson, via e-mail

WDDTY replies: The evidence is clear that single-test readings and even single-day ambulatory monitoring is not an accurate snapshot of BP, but needs to be conducted with multiple readings over a six-month period (see WDDTY’s The Truth About the Dangers of Modern Medicine).

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Written by What Doctors Don't Tell You

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