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Chronic Prescription Drug Use for Big Profits

Suppose you are a middle-aged man, 50 years old, with an acceptable cholesterol level, a non-smoker with a blood pressure of 177/90 as measured at your doctor's office.  Holy spontaneous stroke, heart attack, kidney failure, acne, etc.!  Also, you aren't a white-coat hypertensive, that is, you aren't a person who can generate impressive blood pressure readings just because you don't like being in the doc's office-but otherwise have an acceptable blood pressure ("acceptable" is  currently  a reading under 140/90, but "acceptable" is dropping all the time...  read on).  You buy a home blood pressure monitor and measure your blood pressure while sitting in your favorite chair next to a cracking fire and your trusty dog Bosco by your side, your fur-lined slippers having just been delivered by your Absolutely- Perfect-in-All-Ways Wife, along with a cup of decaffeinated green tea.  The blood pressure reading?-177/90 again.  You, my friend, are about to get seriously medicated.  Upon calling your findings in to your family doc (wifey got the wireless phone for you, of course), The Doc mumbles a common mantra about how you can start taking some anti-hypertensive medication immediately or perhaps not live out the week.  A prescription for an appropriate med is called into the local pharmacy and within hours you are enjoying the side effects of a medication that has, well, well, saved your life!

Now that I've satisfied my urge to write a mini soap opera, let's examine the facts as they are known.  Using the calculator based on the Framington Heart Study [1], you had a 4% chance of having a serious cardiac event  in the next 10 years with your unmedicated 177/90 b.p.  But now your b.p., thanks to a drug that you will be instructed to take every day of your life, is 122/80.  Your doc is happy, you are happy (other than you might feel tired, have leg cramps, be impotent, depressed, constipated, and have a constant headache, etc. due to the side effects of the drug).  Even Bosco is happy, but then, he was happy when you were hypertensive.  So what is your new, improved risk of having a serious cardiac event in the next 10 years  according to the Framington-based calculator?  Maybe 1%?-that would be nice.  Uh, sorry, it's still 4%.

Let me try and cheer you up: sure, you have side effects from your blood pressure medication (which is still patented and cost you about $1,000 a year or so), but you've made some lucky  pharmaceutical company very happy-you will probably be taking that med for the next 30+ years and helping the company's bottom line.  So, there's part of the silver lining.  Your doc will be happy, too (after thinking a bit on your chance of serious cardiac event, you may wonder why, especially if you think of it in positive terms: you have a 96% chance of not having cardiac difficulties in either case). Let me conclude this quasi-sarcastic section with the comment that 177/90 is a blood pressure that is of concern-it's just that lowering the pressure with drugs won't necessarily make you less likely to have a cardiac event. 

The point of my story is that the best drugs from a drug company financial point of view are drugs that are taken regularly-it is no coincidence that drugs that lower cholesterol, blood pressure, and treat depression are literally billion dollar drugs for Pharma-drugs that  are taken daily and indefinitely.  It is important for you, as the consumer, to see through this lens when you read reports of new "research", talk to your doctor (many of whom get most of their new drug information from drug representatives), or watch television. A very simple relationship exists between the level of medical concern over serum cholesterol, blood pressure, and  depression-the lower the bar is set-often by "new studies", the more drugs are prescribed and the more money drug companies make; since drug companies often fund the studies that determine when it is appropriate to medicate a patient, we sometimes have a case of the fox guarding the chickens. 

There are questions as to the current guidelines for daily medication in the three areas discussed (cholesterol, blood pressure, depression), and others-remember, the medical community was just as adamant and sure of themselves in the past when the levels of concern were different. We must not forget the cheerleaders for ever-lower thresholds for introducing medication have a very, very large financial stake in the research outcome. With every drug you consume, there is an element of risk,  so scrutiny of the basis of taking any drug-but especially a drug taken daily, is in order. Think before you allow yourself to be medicated. Ask your doctor questions about any medication you are instructed to take-lots of questions; the good doctors will welcome your concern.     





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