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Clinical · Comorbidities

Hypertension improvement and when medication needs revisiting — a second dataset

RM
r.marsdenTL3Regular6 Oct 2024#1

Posting this under the heading it deserves: Hypertension improvement and when medication needs revisiting — a second dataset Everything below is what sits behind that.

Posting a small dataset on Hypertension improvement. It is mine, it is uncontrolled, and the method is stated so it can be discounted appropriately.

What I would like is not agreement but a second dataset collected by someone with no stake in mine. If one exists I would rather read it than argue for this one.

11 likes 22mo
KB
k.batistaTL27 Oct 2024#2

Where I part company with the opening post, and it is a narrow parting.

The practical value of this subcategory is helping somebody frame the question they take to an appointment, and that is worth being explicit about.

15 likes 22mo
MM
methods_marginTL3Regular7 Oct 2024#3
k.batista, post #2: Where I part company with the opening post, and it is a narrow parting. The practical value of this subcategory is helping somebody frame the question they take to an appointment, and that is worth being explicit about. Go to post

The arithmetic in the opening post is right; the assumption feeding it is the part to check.

My experience of Hypertension improvement contradicts the reply above. I am posting it as a data point rather than as a refutation, because one person's experience is exactly that.

0 likes in reply to #2 22mo
SC
s.chowdhuryTL3Regular7 Oct 2024#4

What I would want before treating Hypertension improvement as settled: the method, the sample, and whether anyone tried to find the opposite result. Two of the three are usually missing.

1 like 22mo
DT
dexa_twice_yearlyTL3Regular8 Oct 2024#5

Building on post #4 rather than restating it.

Asking about a population rather than about yourself is a legitimate framing and generally gets a better answer, because the general case is answerable.

I would want to see it done twice before believing it once.

10 likes 22mo
HF
h.friskTL28 Oct 2024#6

Post #2 put the caveat in the right place and I want to underline it.

Nobody has said the unglamorous part of Hypertension improvement yet, so: most of the variation is explained by things that are boring to write about and easy to check.

22 likes 22mo
GP
g.pemberton_ukTL3Regional · UK8 Oct 2024 · edited#7
dexa_twice_yearly, post #5: Building on post #4 rather than restating it. Asking about a population rather than about yourself is a legitimate framing and generally gets a better answer, because the general case is answerable. I would want to see it done twice before believing it once. Go to post

I would put moderate confidence on the mainstream reading of Hypertension improvement and no more. That is not scepticism for its own sake; it is where the sourcing actually stops.

0 likes in reply to #5 22mo
NB
n.boatengTL28 Oct 2024#8
r.marsden, post #1: Posting this under the heading it deserves: Hypertension improvement and when medication needs revisiting — a second dataset Everything below is what sits behind that. Posting a small dataset on Hypertension improvement. It is mine, it is uncontrolled, and the method is stated so it can be discounted appropriately. What I would like is… Go to post

Gastrointestinal conditions interact with a mechanism that slows gastric emptying in ways that are plausible and largely unstudied.

3 likes in reply to #1 22mo
FD
f.demirTL2Regular9 Oct 2024#9

Taking post #8 at face value and following it one step further.

Eating-disorder history is raised here regularly and is the case where the guidance most consistently says the decision needs specialist input.

The uncertainty is in the assumption, not in the calculation.

15 likes 22mo
AI
a.iyerTL29 Oct 2024#10
k.batista, post #2: Where I part company with the opening post, and it is a narrow parting. The practical value of this subcategory is helping somebody frame the question they take to an appointment, and that is worth being explicit about. Go to post

That is consistent with mine, for whatever one more account is worth.

30 likes in reply to #2 22mo
P
PWendelboeTL1Member9 Oct 2024#11
methods_margin, post #3: The arithmetic in the opening post is right; the assumption feeding it is the part to check. My experience of Hypertension improvement contradicts the reply above. I am posting it as a data point rather than as a refutation, because one person's experience is exactly that. Go to post

Post #9 put the caveat in the right place and I want to underline it.

A history of pancreatitis appears in the cautions for this class and the decision around it is one that needs a clinician who knows the history.

22 likes in reply to #3 22mo
CN
c.nybergTL29 Oct 2024 · edited#12
r.marsden, post #1: Posting this under the heading it deserves: Hypertension improvement and when medication needs revisiting — a second dataset Everything below is what sits behind that. Posting a small dataset on Hypertension improvement. It is mine, it is uncontrolled, and the method is stated so it can be discounted appropriately. What I would like is… Go to post

Reframing Hypertension improvement slightly, because I think the disagreement is about the question rather than the answer. If the question is "does it happen", yes. If it is "how often", nobody here knows.

10 likes in reply to #1 22mo
LS
l.sarkissianTL2Member10 Oct 2024#13

Adding what did not work for me on Hypertension improvement, since the failures never get written up and they are half the useful information.

3 likes 22mo
TM
t.marchettiTL210 Oct 2024#14

The arithmetic in post #13 is right; the assumption feeding it is the part to check.

Where somebody is on several medicines, the interaction question and the comorbidity question are entangled and both belong with a pharmacist.

It is the kind of thing that is obvious once and never again.

0 likes 22mo
I
IHollingworthTL210 Oct 2024#15
NR
n.ramosTL210 Oct 2024#16

Second-hand on Hypertension improvement, so weight it accordingly — someone whose method I trust told me this and I have not verified it myself.

15 likes 22mo
EA
e.almeidaTL2Member11 Oct 2024#17

Everything in post #13 holds. The case it does not cover is the one I have.

Where a condition is well controlled and where it is not are different questions and the published data rarely distinguishes them.

6 likes 22mo
RS
r.sobczakTL211 Oct 2024#18

Narrowing post #17, because the general version has more than one answer.

I have three months of notes on Hypertension improvement and the honest summary is that the trend is real and the week-to-week numbers are noise. I nearly drew the opposite conclusion from the first fortnight.

1 like 22mo
BR
buffer_reviewTL3Regular11 Oct 2024#19
r.marsden, post #1: Posting this under the heading it deserves: Hypertension improvement and when medication needs revisiting — a second dataset Everything below is what sits behind that. Posting a small dataset on Hypertension improvement. It is mine, it is uncontrolled, and the method is stated so it can be discounted appropriately. What I would like is… Go to post

Where the Hypertension improvement discussion usually stalls is that nobody wants to say "I do not know" and everyone is willing to say "it varies". Those are the same sentence with different clothes on.

0 likes in reply to #1 22mo
AC
a.cardosoTL211 Oct 2024#20

This follows post #17 rather than contradicting it.

Nothing here is medical advice and clinicians posting in this subcategory say so on their own account rather than because a rule requires it.

This is the sort of thing the wiki should carry and currently does not.

22 likes 22mo
PA
p.amankwahTL212 Oct 2024 · edited#21

Post #18 is the version of this I will quote in future. One addition.

Summarising the Hypertension improvement thread so far, since it is long and the answer is buried: the first reply has the method, the fourth has the correction to it, and the rest is people agreeing at length.

8 likes 22mo
NR
n.rahimiTL212 Oct 2024#22

Where two conditions pull in opposite directions, that is a clinical judgement rather than a lookup, and it is the kind of question a forum answers worst.

I would rather say I do not know than round it up to an answer.

20 likes 22mo
DP
d.petrescuTL212 Oct 2024#23

Since Hypertension improvement keeps coming up, it should probably be a maintained page rather than a recurring thread. I am happy to draft it if someone with more direct experience will review it.

0 likes 22mo
IC
i.coelhoTL212 Oct 2024#24
h.frisk, post #6: Post #2 put the caveat in the right place and I want to underline it. Nobody has said the unglamorous part of Hypertension improvement yet, so: most of the variation is explained by things that are boring to write about and easy to check. Go to post

Nothing to add, except that this is the answer I would give if asked.

2 likes in reply to #6 22mo
FK
f.kimaniTL212 Oct 2024#25

The failure mode on Hypertension improvement is boring rather than dramatic. It is almost always the step everyone assumes was done correctly because it is too simple to get wrong.

13 likes 22mo
K
KLindqvistTL4 Moderator13 Oct 2024#26

A condition that affects nutrition or absorption changes the calculus around a treatment that reduces intake, and that interaction is mostly unstudied.

27 likes 21mo
VN
v.nascimentoTL213 Oct 2024#27

I would call the community position on Hypertension improvement likely rather than established, and I would be comfortable defending that hedge.

0 likes 21mo
LW
l.wikstromTL213 Oct 2024#28
a.iyer, post #10: That is consistent with mine, for whatever one more account is worth. Go to post

Answering the question post #25 raises rather than the one it answers.

Interactions between comorbidities: diabetes and kidney disease together change the risk calculation for hypoglycemia and for medication clearance. They are not independent variables.

Nothing above should be read as advice about what anyone else should do.

4 likes in reply to #10 21mo
NT
n.torrenceTL3Regular13 Oct 2024#29

A history of pancreatitis appears in the cautions for this class and the decision around it is one that needs a clinician who knows the history.

2 likes 21mo
KA
k.agyemanTL213 Oct 2024 · edited#30

I read the earlier replies on Hypertension improvement twice before writing this, because I had assumed the opposite and wanted to be sure I was disagreeing with what was said rather than what I expected.

9 likes 21mo