Experts Call For Mass Medication Of Brits

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The guidelines would lead to more people taking more

drugs, she said. " There are still a lot of people out

there taking one or two drugs who are not very well

controlled. They need three or four drugs, "

 

 

 

Experts Call For Mass Medication Of Brits

By Jeremy Laurance

Health Editor

The Independent - UK

8-25-4

 

 

A Government agency calls today for the mass

medication of the British population to protect

against a " silent killer " that is threatening the

lives of 40 per cent of adults.

 

High blood pressure affects 14 million people in the

UK and is a major cause of heart attacks and strokes,

but almost 10 million receive no treatment despite the

availability of cheap, reliable drugs, specialists

say.

 

In the most far-reaching drug intervention ever

recommended by an official body, new guidelines

launched by the National Institute of Clinical

Excellence (Nice) call for the extension of treatment

to the millions at risk to save lives.

 

A spokesman said: " This is by far the biggest impact

guideline we have issued because so many people have

high blood pressure. "

 

The World Health Organisation said in 2000 that high

blood pressure was the single most prolific cause of

preventable deaths. It damages blood vessels in the

eyes, the heart and the kidneys and is a major cause

of cardiovascular diseases, which account for 30 per

cent of all deaths in the UK.

 

But despite the havoc it wreaks, most people with high

blood pressure feel well and are unaware their health

is at risk. One-third of the 14 million people with

the condition in the UK do not know they have it, and

a further third who do know are not being treated. Of

the four to five million people receiving treatment,

one third are not being adequately controlled by

drugs, Bryan Williams, professor of medicine and

director of the cardiovascular research unit at the

University Hospitals NHS Trust, Leicester, said.

 

Professor Williams, who was involved in drawing up the

guidelines, said they were among the most robust ever

issued. " Hypertension is often referred to as the

silent killer because it does not present symptoms

until it has already taken hold and caused damage, " he

said. " We hope the impact of these guidelines will

mean fewer people will have strokes and heart attacks.

If the population is to live longer, giving treatment

to prevent disease is the best option even though it

takes a long time to realise the benefits. I think

this is the way to go and it is long overdue.

 

" There is more data on the treatment of hypertension

than on any other treatment in medicine. We can answer

the question of what works with a high degree of

certainty. "

 

Although no estimate has been made of the cost of

extra drug treatment, he said it was " highly likely to

be cost effective " because of the saving in treatment

for heart attacks and strokes. He denied that Nice was

promoting the use of drugs that could cause side

effects for a symptomless condition. Even treatment

with a single drug could cut heart disease by 20 per

cent and the drugs had few side effects, he said.

 

Wendy Ross, a GP in Newcastle who helped devise the

guidelines, said: " Once people start treatment they

are likely to be taking tablets for the rest of their

lives. Most are quite keen to avoid that and want to

find out what they can do [about changing their

lifestyle]. "

 

The guidelines would lead to more people taking more

drugs, she said. " There are still a lot of people out

there taking one or two drugs who are not very well

controlled. They need three or four drugs, " she said.

The NHS spent £840m on drugs for high blood pressure

in 2001, accounting for 15 per cent of the cost of all

drugs prescribed by GPs. Andrew Dillon, chief

executive of Nice, said spending was set to rise

sharply as a result of the guidelines but the amount

had yet to be calculated.

 

Nice also publishes guidelines for the treatment of

dyspepsia (indigestion) today, with a recommendation

that most patients can be helped to care for the

problem themselves with over-the-counter drugs.

 

* One in six hospitals does not have a stroke unit,

which is " unacceptable " , the Royal College of

Physicians said yesterday. A national audit of stroke

treatment found that although the care of patients was

improving, it still fell short of the care given to

heart patients.

 

THE GUIDELINES

 

* People with at least three blood pressure readings

above 140/90 mmHg, taken on separate occasions, should

be offered advice on how to reduce it by changing

their lifestyle, and assessed for their risk of heart

disease.

 

* This may involve changes to the diet, reducing

weight and increasing exercise. Cutting back on

alcohol, salt and caffeine and practising relaxation

may also help to lower blood pressure. Stopping

smoking does not reduce blood pressure but is

important to cut the risk of heart attacks and

strokes.

 

* If lifestyle changes do not work, drug treatment

should be offered to those with a significantly

increased risk of heart disease, based on blood and

urine tests and family history.

 

* People with persistently high blood pressure of

160/100 mmHg or more should automatically be offered

drug treatment.

 

* Drug treatment should begin with a diuretic, which

increases urine production, and further drugs such as

beta-blockers, calcium channnel blockers and ACE

inhibitors should be added as necessary until the

target blood pressure is reached.

 

* The drugs are off patent, available in cheap,

generic form and are safe with few side effects.

 

© 2004 Independent Digital (UK) Ltd

 

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