Target BPs are much lower
Last week the American Heart Association (AHA) and the American College of Cardiologists (ACC) published new guidelines in the diagnosis and treatment of high blood pressure.
What are the new numbers and what do they mean?
Many people will be surprised to find out they now have “elevated” high blood pressure, which could be a reading as low as 120/70, or Stage 1 hypertension at 130/80 rather than 140/90 (the old threshold).
The new blood pressure guidelines are:
- Normal: Under 120 over 80
- Elevated: Top number 120-129 and bottom less than 80
- Stage 1: Top
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October is Breast Cancer Awareness month
October has become the month to pressure women to Buy Pink! and schedule their annual mammograms.
But I’d rather see more women informed about the effectiveness of annual mammograms (not as much as you might think).
And I’d like to see more care providers drop the paternal attitudes and really have a conversation with women about the pros and cons of screening mammograms, and how (or if) this diagnostic tool should be used to meet their health care goals.
I’ve written many posts on this topic, so please check them out!
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More exercise, more soluble fiber
I’ve been posting about my husband’s high cholesterol since it became quite high about a year ago. Last December his total cholesterol was 297, with an LDL (low-density lipoprotein) of 219 and an HDL (high-density lipoprotein) of 65.
Now I’m happy to report that after 9 months of pretty simple lifestyle changes his total cholesterol is down to 240. His LDL (the bad one) is way down at 153, and his HDL (the good one) is way up at 77!
Although he has no other risk factors for heart disease—he’s not overweight, … Continue reading
Choosing Wisely to prevent overtreatment
I’ve been a fan of the healthcare consumer group, Choosing Wisely, for several years.
Collaborating with Consumer Reports, Choosing Wisely brings evidence-based healthcare information to patients. Their goal is to educate patients and physicians, and support informed decision making.
Shared decision making not only prevents patient harm from overtreating, but brings down escalating healthcare costs by eliminating unnecessary diagnostic tests and procedures. (Healthcare waste accounts for billions of dollars every year!)
Now it’s even easier to get access to their information.
The healthcare app, iTriage, has added 160 of Choosing Wisely’s recommendations to … Continue reading
Rethinking LDLs (low-density lipoproteins)
I’ve posted a couple of times about my husband’s high LDL level and his attempts to lower it through diet and exercise.
I’ve also said that because he doesn’t have any other risk factors for heart disease, we aren’t too worried about it. But the engineer in him likes the challenge of seeing how low he can get his LDL.
When I saw this recent YouTube video, however, I had to ask him to watch it. What if everything we think we know about LDL levels is wrong? What if so-called bad cholesterol isn’t really … Continue reading
Unnecessary tests = unnecessary expense
This is a follow up to my last post about the dangers of too much medical care.
One of the biggest doors leading to an overabundance of healthcare and healthcare costs is the annual exam and all the “routine” lab work that is ordered almost without thought.
Doctors’ offices strive to be efficient. They have a lot of patients to see every day, after all.
One way they streamline their practices is to set up routine or “standing” orders for common lab tests, such as an electrocardiogram (EKG), complete blood count (CBC), urinalysis (UA), … Continue reading
Too much testing = too much medicine
I just ran across an old doctor joke: What is a well person? Someone who hasn’t yet been thoroughly examined.
It’s not funny, of course, if you’re the patient and have suffered the harms—and the expense—of too much medical care.
In 2010, my husband was the victim of too much medical care. Because of complications and a string of medical errors he almost died. His care cost our insurance company over $100,000 and we were out of pocket for our $10,000 deductible.
Now he has no thyroid and has to take medication every … Continue reading
Cutting the waste
I’ve posted several times about the Choosing Wisely campaign.
Developed by Consumer Reports and the American Board of Internal Medicine, Choosing Wisely hopes to educate both physicians and patients, and cut back or eliminate unnecessary medical tests, procedures and treatments.
Over-testing and over-treatment are estimated to cost about $200 billion every year. I think that’s a conservative figure, as the financial—not to mention emotional—consequences of too much medicine can be difficult to quantify.
Bringing about change in our behemoth, for-profit healthcare system is a daunting task, and I’m always happy to see signs that it’s catching … Continue reading
How will you use the information?
Home genetic testing kits have been available for several years now.
With a drop of spit and a couple hundred bucks, you can learn a lot about your genetic ancestry and your risk for developing certain diseases.
Although I’d accept without question a report that told me which continent my ancestors hailed from, I’d be much less willing to make decisions about my health based on one of these home genetic testing kits.
Why? Isn’t all information good?
Only if you know what to do with it after you have it.
Dr. … Continue reading
More tests = more money
Anyone who has read my blog over the years knows this is a subject I come back to again and again: the overuse of screening and diagnostic tests.
It’s a problem in our healthcare system for a couple of reasons.
First, the majority of healthcare providers are paid based on volume. In other words, the more patients they see, the more tests they run, the more surgeries they perform, then the more they get paid. It doesn’t matter if the outcome is poor, because they still get paid. In fact, they make even more money … Continue reading