Clinicians Remain Reluctant to Allow Negative Findings to Influence Practice

Jama.jamanetwork.com: October 3, 2012

Results from a recent review of randomized controlled trials suggest that medically treating mild hypertension in individuals with no previous cardiovascular events or cardiovascular disease does not reduce mortality or morbidity. But, as so often happens with negative findings, it remains to be seen whether this evidence will change clinical practice.

The review, by the Cochrane Collaboration, is at odds with current guidelines in the United States and Europe that call for medical therapy if lifestyle changes cannot control an individual’s blood pressure. The Cochrane conclusion follows recent actions by the US Preventive Services Task Force (USPSTF), which has questioned whether screening men for prostate cancer, screening women younger than 50 years for breast cancer, and using electrocardiography to predict coronary heart disease events in low-risk asymptomatic adults provide sufficient potential benefits to offset potential harms.  Read more