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June 10, 2013

Waste and Harm in the Treatment of Mild Hypertension

Author Affiliations

Author Affiliations: Royal College of General Practitioners, London, England. Dr Heath is a retired general practitioner.

JAMA Intern Med. 2013;173(11):956-957. doi:10.1001/jamainternmed.2013.970

The 2012 Cochrane Review on “Pharmacotherapy for Mild Hypertension”1 concluded that antihypertensive drugs used in the treatment of otherwise healthy adults with mild hypertension (systolic blood pressure [BP], 140-159 mm Hg, and/or diastolic BP, 90-99 mm Hg) have not been shown to reduce mortality or morbidity in randomized clinical trials. Will this landmark conclusion affect clinical practice and slow the inexorable expansion of disease categories? It certainly should because overdiagnosis and overtreatment are potent causes of both waste and harm and seem to be operating in the interests of the pharmaceutical industry rather than in those of the patients whom the industry claims to serve.

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