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Old 26th Dec 2013, 18:11
  #24 (permalink)  
gingernut
 
Join Date: Apr 2000
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Yes it's quite interesting Ulster, we start with a patient in need, and we all have a little scuffle over the evidence.

Personally, I reckon that's a healthy sign. I reckon we've sorted out patryan's queries between us.

So what about the evidence ?

The diastolic vs systolic question is quite interesting. It's based on "expert opinion," and, to be fair, it seems sensible, that a raised diastolic (which accounts for 2/3's of the cardiac cycle), is more damaging than a raised systolic (which accounts for 1/3 of the cardiac cycle.) Outcome based studies refute this.

Doctors used to base much of their practice on this sort of thing, nurses even more so.

It's a fair enough assumption, but when you start looking at more robust studies, (studying interventions and outcomes), it would appear that the picture is more complex.

The latest hypertension guidance is a little bit of a mish mash, combining the opinion of the great and good, (poor evidence) a few cohort studies, (mid range evidence) and the odd incidental finding from an RCT (better).

Merry Xmas, Nurse (with an attitude), Ginge.
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