Doctors look to guidelines from highly regarded thought leaders to figure out how to treat common problems like high cholesterol or prostate cancer. But how objective are these publications? Dr. Steve Nissen of the Cleveland Clinic calls out his colleagues and says too often they have significant conflicts of interest that make the guidelines less useful for patient care–but physicians don’t always realize where the conflicts lie.
Treating high blood pressure is important to cut the risk of strokes, heart attacks and kidney disease. But how high is too high? The Cochrane Review last year concluded that there is no scientific evidence of benefit from treating blood pressure unless the upper number is above 159 or the lower number is above 99. We talk with a physician about this evidence and the dangers of overdiagnosis and overtreatment.
The maker of Tylenol has long presented it as a safe pain reliever. But for decades, scientists have known that the ingredient in Tylenol, acetaminophen, can cause liver damage at doses only slightly higher than the maximum labeled OTC amount. It took the FDA a very long time to require consumer warnings on the label. What gives? You may want to read the in-depth ProPublica report or listen to This American Life.
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Guests: Steven Nissen, MD, is chairman of the Robert and Suzanne Tomsich Department of Cardiovascular Medicine at the Cleveland Clinic. He is the co-author, with Mark Gillinov, MD, of Heart 411: The Only Guide to Heart Health You’ll Ever Need. The photo is of Dr. Nissen.
Iona Heath, MA, MB, BCh, is a retired family practice physician from London, England. Her viewpoint article, “Waste and Harm in the Treatment of Mild Hypertension,” was published in JAMA Internal Medicine on June 10, 2013.
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