Myth: Better safe than sorry
February 4, 2024, 1:43 PM IST / Lalit Kapoor in FIVE PILLARS OF HEALTH: A Blueprint for Wellbeing, Health, India, Lifestyle, TOI
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The blog challenges the common perspective of "better safe than sorry" in the context of medication for lifestyle diseases, particularly focusing on elevated blood pressure, blood sugar, and cholesterol levels. It introduces the concept of the J-Curve, suggesting that excessive medication might pose more harm than the absence of medication. Over the past two decades, senior doctors have recognized a tendency to overmedicate, prompting a reevaluation of guidelines for medication thresholds.
The blog promises to present evidence supporting the need for revised guidelines towards more moderate medication thresholds. It also aims to explore the intricate dynamics of the pharmaceutical, food, and healthcare industries, shedding light on the influence of government and media on public health perceptions.
Highlighting the flaws in previous approaches, the blog emphasizes the potential harm of overmedication, especially in the face of increasing specialization in medicine. The discussion touches on the limited understanding of drug interactions and the risks of Adverse Drug Reactions (ADRs), with a promise to delve deeper into ADRs in future blogs.
The narrative shifts to the human body's remarkable self-healing ability, contrasting it with the challenges posed by synthetic medications. The blog encourages addressing health markers through diet and lifestyle changes before resorting to medications, stressing the importance of seeking medical advice and discussing preferences with a doctor.
Introducing the J-Curve concept, the blog explains that minor deviations from normal health markers are often less harmful and more manageable than more severe deviations. The impact on life expectancy is depicted as nonlinear, with a focus on the significance of a moderate approach to achieve optimal results.
The discussion extends to the drawbacks of medications, acknowledging negative side effects that may reduce life expectancy. The goal of minimizing or eliminating medications is highlighted, particularly for individuals on multiple medications for conditions like high blood pressure, diabetes, and cholesterol.
The ACCORD study becomes a significant example, revealing that intensive control of blood sugar, blood pressure, and lipids had unintended consequences, increasing all-cause mortality rates among patients. The study's impact prompts revisions in diabetes guidelines by the American College of Physicians (ACP) in 2018.
The subsequent ACCORD study developments lead to calls for revisions in guidelines for blood pressure and blood sugar medications. The Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC-8) revises its guidelines in 2014. However, the revisions face objections from those with vested interests, leading to shifts in authority within the healthcare landscape.
The blog ends by underscoring the importance of being aware of these recent revisions and potential overmedication, urging readers to discuss these issues with their healthcare providers promptly. The author's goal is to inform readers about the J-Curve concept and its implications, highlighting the need for a balanced and informed approach to medication and healthcare.
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