This is a pleasant surprise, at the
least the part of not having statins shoved at us. I am surprised
that this study was allowed to go forward or even be published since
statins are not mentioned. It is going to be
very interesting to see how long this study stays posted before
people are asking that it be pulled because statins are not mentioned
or recommended.
Now, to the study, which says patients
have time to learn lifestyle changes before drugs may become necessary.
This is for people diagnosed with diabetes and hypertension. It
could have included prediabetes and should include this. The savings
for cost analysis would have been greater and possibly easier for the
patients to adjust their lifestyles.
While the study mentions diabetes, it
on the control of high blood pressure as the key for the time allowed
before medications are needed. Yes, some people are able to manage
diabetes without medications and this should be the goal for all
patients. Some may need medication assistance until lifestyle
changes are made to prevent potential complications from developing,
but the goal should be to get off medications if possible.
This study is important as it shows
there is a potential window available without severe consequences for
people to adopt lifestyle changes to reduce the effects of
hypertension before high blood pressure medications are necessary.
To quote the study statement, “The
consequences of delaying effective hypertension treatment for up to a
year were small - a two-day reduction in quality-adjusted life
expectancy - according to a study by University of Chicago
researchers published online for the Journal of General Internal
Medicine. But as the delay gets longer, the damages multiply. A
ten-year delay decreased life expectancy by almost five months.”
While no mention is made about
cholesterol and statins, this can be a good thing as too often this
is an automatic thing for doctors to prescribe especially when
diabetes and hypertension exist in the same patient. If lifestyle
changes can be accomplished within one year, then it should also be
possible to avoid the need for statins as the cholesterol readings
generally follow the blood pressure readings brought on by lifestyle
changes.
The study also emphasized the
importance of working with the patients to learn how to make the
lifestyle changes and receive the support for making them. The
American Diabetes Association (ADA) recommends only allowing a
three-month trial of medication-free lifestyle therapy for patients
with moderately elevated hypertension. This is a good reason for
doctors to know of this study and allow the patients up to a year for
making the lifestyle changes.
“This study
argues that caregivers should work with patients to help them gain
the knowledge and develop the necessary skills gradually rather than
rushing to drug treatment, especially if their blood pressure is only
mildly elevated. It suggests that patients and providers "have
more time," the authors write, "at least up to one year, to
focus on diabetes self-management and lifestyle modification."”
The ideas put forth from this study are
needed, but I would agree that sometimes it might be necessary for
medications to be used when the test results are in excess of the
upper limits. Patient safety should be exercised to bring diabetes
and hypertension under good management while the patient is taught
how to use and manage lifestyles changes to the fullest.
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