Family physician's critique: the 130/80 blood-pressure threshold and 'intellectual conflict of interest'

Before you act: Don't stop, replace, or delay any treatment without talking to your doctor.

“Should we call this change as overdiagnosis?”

Evidence level

Physician's published review/commentary. Not a clinical study.

Funding

No funding statement shown in the article; single author in clinical practice (Takachaya Clinic, Japan).

What was published

A review of the 2017 ACC/AHA hypertension guideline, which lowered the hypertension threshold to 130/80 mmHg.

What it shows

"It is a serious intellectual COI that the Chair of the SPRINT trial steering committee was commissioned as chair of the guideline panel." "The new threshold would lead to 46 percent of the U.S. adult population being categorized as having hypertension, while using the previous threshold that figure would be 32 percent." It notes the American Academy of Family Physicians declined to endorse the guideline.

What it does not show

It is an opinion and analysis piece; it does not show that the 130/80 threshold causes harm, and it concerns intellectual rather than financial conflicts.

Documented counterpoints

Defenders of the guideline have said panel members had no relevant industry ties and that SPRINT investigators recused themselves from related votes (we have not independently reviewed those statements).

Source link

• J Gen Fam Med 2018;19:123-126, DOI