One of the big things which hit the health news headlines this week was the report that patients with 'occasionally high' blood pressure are at greater risk of developing a stroke than those with consistently high blood pressure. Management of hypertension is a vital aspect of preventative medicine, particularly in a primary healthcare setting. I'm seeing this alot at the moment most likely because I'm half way through a 4 week GP placement. The article appeared in The Lancet this week and a review was published today:
Limitations of the usual blood-pressure hypothesis and importance of variability, instability, and episodic hypertension Volume 375, Issue 9718, Pages 938 - 948, 13 March 2010
The argument is that up until now, sporadically increased episodes of blood pressure have been ignored and too much focus has been on "widespread belief that underlying usual blood pressure can alone account for all blood-pressure-related risk of vascular events". In fact clinical guidelines recommend that episodic hypertension is not treated. At the moment the NICE guidelines on management of hypertension are currently being re-written and no doubt this new evidence will play an important part in new recommendations.
On Doc2Doc there was a post from the author of the site about parking charges for hospitals, it seems that in Dundee we are not alone in having to pay for parking! In some hospitals there are monthly rates of £50 or more.
A case recently saw a doctor being taken to court for refusing to pay a £10 parking fine 'on principle' for parking in an illegal space whilst on duty. The article seems to focus alot on doctors but doesn't talk about the barrier's this poses to patients coming to the hospital which is probably more of a concern. With failure rates at appointments running at an all time high and constant chat about "increasing productivity and efficiency within the NHS to save costs" this is surely the kind of thing which needs to be looked at.
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