Leisure, Lifestyle & Wellness
Hypertension: Raising the Pressure
Medical students are being taught to rely on outdated, potentially dangerous drugs for treatment of hypertension
 
health, high blood pressure, hypertension, diabetes, chronic kidney disease, There is something called the joint national committee (JNC) on the prevention, detection, evaluation and treatment of high blood pressure, or hypertension, in the United States. ‘JNC8’ means the report of the 8th committee—there have been seven previous ones. Experts brainstorm on meta-analyses of clinical researches and studies within a timeframe, review previous guidelines and make recommendations. JNC7 was published in 2003 and, so, everyone expected that, by 2010, JNC8 should be out. It was not to be. JNC8 got delayed for three years and came out with its guidelines only in December 2013. It recommended that patients, aged 60 years or older, start treatment if their systolic blood pressure is more than 150mmHg or diastolic blood pressure is less than 90mmHg (150/90mmHg, or just 150/90 in common parlance) and try to be within these thresholds. In patients aged 18-60 years, treatment initiation and goals should be 140/90. The same goals apply to patients with hypertension, diabetes or chronic kidney disease (CKD).
 
There was strong dissent from five panelists and that upset the whole drug lobby. If people are informed about the ‘normal’ BP measurements, Big Pharma will be the biggest loser as millions will need no drugs. When the JNC5 report came out, a similar noise was made, because JNC5—for the first time—recommended thiazide diuretics as the first choice drug. This was strongly resisted by the ‘thought leaders’ in the US who put forward their own guidelines. Most of them were later found to be on the payroll of Big Pharma. JNC8 committed a greater sin. They honestly reviewed the data and raised the levels for treatment by drugs. These higher levels will take millions of people out of the drug list, costing Big Pharma billions of dollars! How could that be? How can they sustain a loss? Even in JNC8, 25% of the committee members had industry connections; they were only allowed to give their opinions but not vote for the final recommendations. 
 
The drug industry did try its best to stop the report from coming out: it is a surprise that the report did come out in 2013. Now that the report is out and recommendations made, the industry is trying various tricks, using ‘important’ medical associations—like medical unions—to block it. 
 
The other day, I was lecturing to medical students in Pune. One student in the audience told me that they were told about the JNC8 recommendations but were told not to use that for their future practice and use JNC7 instead! 
 
JNC8, along with the famous MRC (medical research council) study of mild-moderate hypertension published in BMJ (British Medical Journal) in 1985, makes an interesting study. What doctors read from journals becomes understandable if they have an elementary knowledge of statistics, as treatment depends on probabilistic factors. There exists what is called NNT or number needed to treat. The MRC study showed that, to save a probable one stroke in a group of 5,000 people in the next five years, one has to unnecessarily treat 850 otherwise healthy people with potentially dangerous anti-hypertensive drugs for five years; ADRs, adverse drug reactions, of these drugs could, by then, damage and/or kill 75 people!
 
Four randomised controlled trials published in 2012 showed no difference between the treated and untreated individuals in the incidence of coronary heart disease, stroke, total cardiovascular (CV) events, and death. About 9% of patients treated with drugs discontinued treatment owing to adverse effects. Treating mild hypertension provides little prevention of CVD in the short term.
 
Dear readers, there is much more than what meets the eye in this profit-oriented sickness-care industry which considers its stakeholders and shareholders dearer than the life of poor patients. The last category is only a statistic for them.
 
(Professor Dr BM Hegde, a Padma Bhushan awardee in 2010, is an MD, PhD, FRCP (London, Edinburgh, Glasgow & Dublin), FACC and FAMS.)

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Twitter claims it's bigger than Facebook

Twitter's remarks came during Deutsche Bank's technology conference recently where he observed that Twitter is equal, or perhaps, even bigger than Facebook

 

With the Facebook user base touching 1.49 billion - or roughly 20 percent of the world's population - can any social networking site claim to be bigger than this? Well, Twitter does.
 
Although it has reported 316 million users in the second quarter - around five times less than Facebook's figure - and its stocks not doing very well either, it did not deter Twitter's chief financial officer Anthony Noto recently observing that Twitter was not behind Facebook, Quartz reported.
 
Noto's remarks came during Deutsche Bank's technology conference recently where he observed that Twitter is equal -- or perhaps even bigger than Facebook -- "depending on how you measure it".
 
"I often get the question from friends [who] are like, ayou know Facebook has over a billion users', and I am like, 'well, we have an audience, depending on how you measure it, that's pretty comparable," he was quoted as saying.A
 
"But they only have that audience, they only have the 1.4 billion they report, there's no other number. We have other audience numbers that no one talks about and when you add those up it's a big number, in fact in some scenarios you could argue that it's bigger," Noto added.
 
The "other numbers" that Noto was referring to are logged-out users (people visiting Twitter who don't have accounts or don't log in) and those who see syndicated or embedded tweets elsewhere.
 
In July, then-CEO Dick Costolo told analysts that half a billion logged-out users come to Twitter each month, and there are even more people who see tweets distributed via partners, such as CNN and ESPN.
 
Disclaimer: Information, facts or opinions expressed in this news article are presented as sourced from IANS and do not reflect views of Moneylife and hence Moneylife is not responsible or liable for the same. As a source and news provider, IANS is responsible for accuracy, completeness, suitability and validity of any information in this article.
 

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COMMENTS

Abhijit Gosavi

1 year ago

The reason Twitter is losing users is that unless you're well-known, you won't get much interaction there. On Facebook, obviously, there's interaction with your personal friends. For any for-profit entity, the bottom line of revenue ads cannot be ignored; Twitter needs to be very worried.

Sun Pharma to sell two divisions to Strides

In a statement issued jointly with Strides, Sun Pharma said the two have entered into a definitive agreement related to Solus and Solus Care divisions of erstwhile Ranbaxy

 

Indian drug major Sun Pharmaceutical Industries Ltd will sell its two divisions operating in the central nervous system (CNS) segment to Strides Arcolab Ltd for Rs.165 crore.
 
In a statement issued jointly with Strides, Sun Pharma said the two have entered into a definitive agreement related to Solus and Solus Care divisions of erstwhile Ranbaxy.
 
According to the statement, Sun Pharma will transfer the two marketing divisions along with the employees to Strides.
 
The two divisions have been accounting for a revenue of Rs.92 crore.
 
Commenting on the transaction, Abhay Gandhi, CEO - India Business, Sun Pharma said: "The agreement with Strides is part of our strategy to firmly consolidate our CNS business in India."
 
According to him, post successful completion of Ranbaxy's merger the company had an opportunity to assess the entire portfolio of its India business.
 
"We have evaluated each and every therapy segment that we are present in and how these businesses can grow going forward. Based on this evaluation, we firmly believe that the potential of Solus and Solus Care divisions can be greatly enhanced with the focus that Strides will put in growing them," he was quoted as saying in the statement.
 
According to Subroto Banerjee, president-Brands, India of Strides, the acquisition of the two divisions will enable growth of the company's branded business in India.
 
The transaction is subject to approval from the Competition Commission of India and other customary closing conditions. All other terms and conditions of the transaction are confidential, the two companies said.
 
Disclaimer: Information, facts or opinions expressed in this news article are presented as sourced from IANS and do not reflect views of Moneylife and hence Moneylife is not responsible or liable for the same. As a source and news provider, IANS is responsible for accuracy, completeness, suitability and validity of any information in this article.
 

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