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.