Thursday, 5 May 2011

Preventative drug treatment based on age – a slippery slope?

A new study issued by the Wolfson Institute today recommends that all those over 55 years of age should be offered drugs to lower cholesterol and blood pressure.

The authors state that age is the biggest risk factor for cardiovascular disease such as stroke or heart attack and suggests that blanket treatment is the most cost effective way forward.

The study was a theoretical comparison between the effects of screening just by age, with whether someone is a smoker, or has raised cholesterol or blood pressure. It concluded that the detection rate would be similar and ‘false positives’ (i.e. treating someone over 55 to prevent a disease that they would not have developed or wrongly diagnosing risk through screening) were also the same.

The suggestion of a pre-emptive strike based purely on age is brave and surely has some merit. Simply offering preventative measures to an age group at risk of life-threatening disease has been compared with childhood vaccination programmes. But there is a significant difference here.

Is this the start of the slippery slope I wonder? The slope that ignores the degree of personal responsibility that we need to impress on patients and the general  public? You cannot stop the sands of time, and however much botox, nipping and tucking goes on, the years rush by. The statistics demonstrating that risk of cardiovascular disease increase into middle-age are undeniable. But so is the fact that a healthy lifestyle, good diet, exercise, and avoiding smoking can also have a significant, positive effect on risk factors.

Do we really want to encourage a pill popping generation? Every medicine has it’s risks and statins, used to reduce cholesterol are no exception. If a general practitioner is going to routinely prescribe these drugs to all their patients over 55, they should routinely screen them as well. So why not stick to the system of screening in the first place?

I agree that every stroke and heart attack prevented is pain and suffering avoided and should be welcomed. But how much better to encourage people to take measures that will not only reduce the incidence of cardiovascular disease, but also all the related nightmares of smoking and obesity such as diabetes and cancers.

Changing the nation’s psyche and attitude to healthy living is far more beneficial than handing out medication to at least 21% of an age range who don’t actually need it. Closing the door after the horse has bolted is one thing – but barricading the stable when the horse was either in no danger of going anywhere or could be taught to behave is another.

1 comments:

Caz said...

I couldn't agree more!
All too often I see people using these drugs to lower cholesterol and in doing so they are not changing their lifestyle which has been a major contributing factor to the high cholesterol in the beginning.
Surely a change in lifestyle should be the initial step with drugs an option for cases that do not respond to this.

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