The usual way that people with diabetes control hypertension -- high blood pressure in normal English -- is with medication. These drugs include everything from diuretics and beta blockers to ACE inhibitors and ARBs and more. Unfortunately, like all drugs, they all have their unwanted side effects. If we could control high blood pressure without drugs, we could do away with all those nasty side effects. Now, it seems that we can. Not that I was quick on the draw to recognize that fact. The Israeli company InterCure makes the RESPeRATE device that we can use at home to control high blood pressure. I've know about it for years and actually once blocked its ads on my website because one of my advisers didn't like the testimonials on InterCure's site. Now that we have taken a closer look at RESPeRATE we realize how wrong we were. Sorry about that.
When you use this little device, which looks to me like a blood glucose meter on steroids, you put on the headphones and attach the sensor around...
A newly published study, The Role of Clinical Uncertainty in Treatment Decisions for Diabetic Patients with Uncontrolled Blood Pressure , points out that people with
diabetes and hypertension (AKA high blood pressure or HBP) often see their
physicians, have high BP readings, yet don't have their HBP treatment adjusted.
The authors give examples of
why physicians procrastinate, ranging from the obvious (the patient showed up at
the clinic for another problem that took priority) to the seemingly bizarre (if
more than one reading was obtained, which blood pressure value or which
combination of values would best represent a patient's true blood pressure).
Perhaps of some concern is
that the authors only investigated the behavior of primary care Veteran's
Administration physicians; whether the behaviors of private-practice
physicians, specialists, or Nurse Practitioners or Physician Assistants would
be different can only be speculated. It might well be worse in other settings,...
My doctor didn't give me one of the new drugs that are good for my blood pressure. Is this because she is not up to date? Recently the New York Times ran an editorial and several pieces on the "Op Ed" page about lecturers having conflicts of interest when giving such lectures. I am currently on a plane preparing to give grand rounds to doctors at a community hospital on the subject of hypertension control. At this particular hospital, and others at which I have lectured, they were quite careful to make sure that I disclose any such conflicts. As do many other physicians, I receive indirect support for some of my research from drug companies. It is indirect because the research that I do has to do with adjudication (or judging) of adverse events, reporting of side effects, and what is called "investigator initiated research" (not related to the use of the drug or device, directed at finding out why the disease does what it does). As such, the type of...
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