Modern medicine is turning healthy elderly people into patients, warns a senior doctor in an article published on bmj.com today.
Michael Oliver, Professor Emeritus of Cardiology at the University of Edinburgh, argues that many people over 75 are "started on pills" for high blood pressure or diabetes or high cholesterol with little consideration of the actual benefits to the individual.
AdvertisementHe believes that preventive action may be irrelevant and even harmful in the elderly.
For example, about 75 elderly people with mild hypertension may have to be treated in order to prevent one from having a stroke. Therefore, the other 74 will be committed to treatment for life, he explains.
Oliver puts this trend down to many causes, including over enthusiastic and uncritical interpretation of guidelines, the demands of government health economics, and the endless pressures from pharmaceutical companies.
Instead of making several measurements or investigating possible causes, the conclusion is to tell the person that he or she has raised blood pressure and that it must be treated, he writes. Yet the actual evidence for benefit of treating any risk factor in those over 75 needs much more careful consideration when applied to an individual.
He suggests that guidelines should not be regarded as commandments to investigate and treat, and that the balance between the risks of treatment and the untreated risk are explained fully to the individual.
Bureaucratic demands for documentation can lead to over-diagnosis, over-treatment and unnecessary anxiety, he concludes.
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