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Blood pressure treatment effective in elderly

Rating

4 Star

Blood pressure treatment effective in elderly

Our Review Summary

This report, about findings of an important clinical trail about the treatment of high blood pressure with generic drugs in the elderly, follows many best practices for health journalism. 

  • It is based on a high-quality clinical trial published in a major journal
  • It uses a number of sources in addition to the study’s lead author
  • It reports the findings in sufficient detail to help readers understand the benefits of treatment
  • It puts the findings in context of previous research

The story could have been improved in two ways:

  • By indicating the underlying risk of the various measured outcomes in this population–so readers can appreciate the magnitude of (say) a 23 percent reduction in heart-related deaths. Given what we can assume about the risk of death and cardiovascular disease in this elderly population, however, this does not appear to be a serious shortcoming in this particular report. 
  • By adding the perspective of a geriatric clinician who can put these findings in context of current practice. This would have permitted the story to include any other treatments for high blood pressure used in this group.

One final observation: Because the study is British, the two medications studied are not the most commonly prescribed in the diuretic and ACE inhibitor classes in the U.S. This would have been useful to note to help patients talk to their doctors about these drugs. 

 

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

While the drugs used are inexpensive generics, it would have been useful to cite the costs in some way–per day, per month, per year, etc.  For those paying out of pocket for their medications – particularly elderly on fixed incomes – the costs of even generics can add up after they are on several medications. 

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Satisfactory

The story uses considerable detail to specify how much the treatments reduced overall mortality, stroke, and death from stroke, cardiovascular events or heart failure.

The story also reports the mean reduction in blood pressure in the treatment group. 

The only shortcoming here is that the article reports percent reduction in risk without indicating the underlying risk of the cited outcomes (death, strokes, etc.) 

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

The article reports that lowering blood pressure below 150 systolic could lead to dizziness. But it does not mention other side effects associated with ACE inhibitors and diuretics. 

Does the story seem to grasp the quality of the evidence?

Satisfactory

The article is based on a randomized, controlled, multi-center clinical trial published in a top-rank medical journal.

Does the story commit disease-mongering?

Satisfactory

The article does nothing to exaggerate the severity or frequency of hypertension.

Does the story use independent sources and identify conflicts of interest?

Satisfactory

Sources include the study’s lead investigator; a prominent researcher in the field not connected to the study; the author of an editorial published with the study; and the paper itself.

The article discloses, in the last paragraph, the financial relationships that may compromise the researchers’ objectivity.

The story would have been improved if an independent geriatric clinician were interviewed to put the findings in context of typical treatment in this group. 

Does the story compare the new approach with existing alternatives?

Not Satisfactory

The article does not report on other treatments for hypertension in the elderly.

Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

The article makes clear that the anti-hypertensive drugs studied are widely available.

Does the story establish the true novelty of the approach?

Satisfactory

The article does not suggest that use of these well-established generic drugs to control hypertension is novel.

But it does make clear that the findings–that treatment in this population reduces risks of death and some cardiovascular diseases–is new. 

Does the story appear to rely solely or largely on a news release?

Satisfactory

The article is based on a published study presented at a medical conference, not a press release.

Total Score: 7 of 10 Satisfactory

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