Friday, 14 January 2011

Combination better than one?

"High blood pressure" I think most people have heard and familiar with this disease. We know that when people get older or have a lot of pressure or stress, they have a risk to high blood pressure. Many people don't think this disease is too dangerous for health; however it can increase the risk of stroke and heart disease. Because millions of people have high blood pressure, it's challenging to find the best way to treat it. When I read the article 'High blood pressure combination pill 'better than one', I think it's interesting because it sounds like we move forward to something better.

According to the article, doctors normally give a patient one drug and then add another if blood pressure still stays high. Drugs which usually given are aliskiren (a type of renin inhibitor) and amlodipine (a long-acting calcium blocker). However, the study conducted by researchers from University of Cambridge, University of Glasgow and University of Dundee which followed 1,254 patients with high blood pressure in 10 countries found that patients received the combination of drugs (aliskiren and amlodipine) which given as a single pill had better feedback, lower in systolic blood pressure and fewer side effects compared with those given usual treatment. Professor Jeremy Pearson, associate medical director, said that this study shows that combination pill is safe and more effective than waiting to take another drug later. However, the later research fund by the British Heart Foundation found that combination pill may not work for every patient with high blood pressure.

My mother also has high blood pressure. She has to take drugs three times a day and two drugs each time. If drugs can be combined in a single pill, it's easier for patients to take. However, I have questions in my mind. According to the article, doctors will give another drug to a patient if the first can't lower blood pressure. This means that for some patients if the first drug can reduce their blood pressure, they don't need another. If doctors give combination pills to every patient, how can they know that only one drug doesn't work for those patients and if patients get drug that they don't really need, are there any side effects in their bodies? I agree with the point that it's easier to take combination pill but only in cases which doctors are sure that only one drug won't work for patients. On the other hand, if it's not sure that whether patients need a combination of drugs, I think it's better to check before giving them combination pills.

In addition, I think research may not be the strong evidence to prove that combination pill is safe and more effective than taking another drug subsequently. First, research didn't give some information about 1,254 patients they followed. How old are they? How many male and female? How many patients they surveyed in each country? and How long did they do this research? I think these details are important because age, sex and other conditions are necessary for choosing medication to cure high blood pressure. Also, only 1,254 patients in 10 countries seems to be a small group of example compared with people having high blood pressure in many countries. I think research need to work on more patients to strongly prove that combination pill is safe and effective. Finally, because research was fund by the pharmaceutical company which produces high blood pressure medicines, this make me doubt that there are hidden agenda for doing this research. Professors participating in this research only talk about combination pill's advantages but not say anything about negative aspects. So, this research gives benefits to the company which gave research funding. Although approved to use in the US last year, I only like the idea that a combination pill makes patients more convenient to take. However, it still need stronger and clearer evidence to support that combination pill is really better than waiting to take another drug later.
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References
Briggs, H. (2011, January 13). High blood pressure combination pill ' better than one'. BBC News. Retrieved January 13, 2011 from http://www.bbc.co.uk/news/health-12170196

4 comments:

  1. Sorry for late posting, Peter. I have problems with posting. I wrote it in MS Word but I couldn't paste it in the blog. So I had to rewrite in the blog again. It took quit long time for me because I can type slowly. However, I have learned things about this blog and I think I'll do better next time.

    ReplyDelete
  2. Bow,
    Although I suggest writing directly in the blog, with the exception of the References section entries, if you do write first in MS Word, the easiest way to turn turn it into plain text suitable for the blog is to paste it into Notepad, which strips out all of the formatting, and tehn copy and paste from Notepad into the blog.

    I'm trying to find a bit more about the mysteriously missing "Remove Formatting" tool. I've been blogging for a few years now, so have learnt some useful ways to do things, but I don't really know much computers, programs and the like. I usually blame problems in room 201 that vary from the way things work on my home computer on AUA's set up, but perhaps there is something else at work here. I'm sorry. I just don't know at the moment.

    As much as possible, I prefer to work at home on my computer, where everything is familiar and set up just the way I like it. And it all works in reliable, expected ways.

    I noticed yesterday that at least one person had an iPad. Can you access the internet on an iPad at AUA? I'm not about to rush out and buy an iPad, but for those who have one, that would seem like a reasonable and sensible option to enable.
    Does anyone know?

    And now I'm thinking I should maybe have made this a new blog post. I haven't talked about blood pressure drugs at all. But I want to, sort of.

    ReplyDelete
  3. I also saw the headline on the BBC's front page about using a combination of drugs for high blood pressure, but without Bow's personal interest in the story (my 80 year old mum does have some minor health issues, but blood pressure isn't one of them), it didn't attract me enough to even go to the story for a look.

    However, there are a couple of things in Bow's response that do attract me. The first is that she emphasises the importance of evidence to support an idea. But even better are the questions she raises about opposing evidence and ideas, such as possible negative side effects. Bow makes the point very well that just because something has one apparent benefit might not be a good enough reason to do it; there might be other consequences that are so serious as to make it a bad policy, for example, raising the age at which cigarettes can be legally sold to someone. (And now you can probably guess what the main idea of my persuasive paragraph from Monday is.)

    ReplyDelete
  4. Thanks for your suggestion, Peter. I'll do it next time. Actually, I also have no "Remove Formatting" tool in my laptop. Win has an iPad and I saw he could access the internet on an iPad at AUA. I'm not sure how but I'll ask him later.

    ReplyDelete

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