frankly佢講嘅嘢冇咩重大錯誤,但最大問題係避重就輕
攞哂最嚇到人嘅side effects出嚟講,好處隻字不提
warfarin嗰part更加係攞嚟講,如果真係有醫生開warfarin嚟醫 hypertension佢可以考慮下向醫委會投訴
書恕我冇咁得閒睇,但就嗰份paper可以講兩句
(Blood Pressure Changes in 1610 Subjects With and Without Antihypertensive Medication During Long-Term Fasting)
佢嘅論據可以證明斷食 / 減肥有用,而現代醫學確實support呢樣嘢
lifestyle modifications同pharmacotherapy不嬲係相輔相成
但佢講到食藥有問題,「唔搵原因就降低佢一定奶嘢」,就係偏頗
最新嘅WHO pharmacological treatment of hypertension guideline recommendations係綜合咗14份systematic reviews所得出嘅結論
"The anticipated benefits of a lower blood pressure (BP) target (140 SBP in the general population and 130 SBP in a high-risk population) were reduction in mortality, cardiovascular mortality, stroke, myocardial infarction (MI) and heart failure events. The anticipated harms were mostly not serious side-effects, and some were a surrogate outcome, such as rise in creatinine that may not be clinically relevant. On average, treatment was associated with a reduction in deaths and cardiovascular events that ranged from 5 to 10/1000 and harms that ranged from 20 to 30/1000. The benefits were a reduction in severe events with significant morbidity and mortality whereas the harms were mostly not clinically significant."
用「奶嘢」嚟形容呢啲benefits,鬧佢痴線簡直係understatement
做healthcare / 想普及healthcare information嘅,how you present同what you present一樣重要
要確保病人make an informed decision,避重就輕同misinformation係差唔多咁仆街
不過有兩點值得講
1. 有部分醫生唔夠強調lifestyle嘅重要性,冇urge某啲有modifiable risk factors嘅病人去做食藥以外嘅嘢,確實唔理想
2. 藥同lifestyles唔會one-size-fits-all,醫生同病人喺能力範圍內應該試唔同嘅方法,睇下邊個最適合(當然香港夠唔夠資源搞係另一個問題)