The BMJ is doing well this week (see website of the week). This recommendation is for its publication of the British Hypertension Society’s guidelines. These nine pages are a handy condensation of the 47 pages of the full report.
This is something we all need to know, and to find the essential points it is enough to look at all the tables and boxes that cover just about everything. These include the indications for ambulatory monitoring, routine investigations, evaluation of the hypertensive patient, when to refer, thresholds for treatment, and therapeutic options.
Why go there: essential reading.
Downside: you need to avoid information overload.
Information from: BMJ and British Hypertension Society.
Information for GPs
This charity is for medical professionals rather than patients and its aims include understanding the origins of hypertension through research, and improve its treatment. The site has a professional look and is easy to navigate. There are masses of educational workshops on offer, a directory of hypertension referral centres and lists of publications.
A particularly useful section lists validated BP monitors and another has downloadable PDFs about various aspects of the prevention and management of hypertension. There is an excellent table that interprets estimates of glomerular filtration and relates the data to clinical parameters.
Why go there: top-quality site for GPs.
Information from: British Hypertension Society.
I didn’t find this site particularly user friendly; the homepage is too busy and it is not obvious how to find what you want.
For example, I would have thought that the thing that might make a patient want to seek out this site is because they had been diagnosed with hypertension and wanted to know about it. But you have to click on a not very obvious link called ‘information’ and then another link to ‘what is high BP?’
But there is much to like about the site. It offers free membership and information packs, and advice about aspects of management such as the importance of salt, and information directed specifically at African-Caribbean patients.
Why go there: good for patients.
Downside: design not so hot.
Information from: Blood Pressure Association.
Cure your bP?
You cannot cure hypertension, but there are more than a few out there who choose to ignore this fact. If you put ‘cure blood pressure’ into Google, you get 29,500,000 hits. One that came near the top of the list was Hyperexol. It is a mixture of garlic, vitamins C and B6, calcium, magnesium oxide, selenium, potassium gluconate, hawthorn berry powder, L-taurine and cayenne pepper powder.
The site claims to tell you how it works, but what follows is a claim of what it does. Clinical trials show it works, they say, and one massive trial of a whole 22 patients proves this. It has a nanotechnology delivery system. And after 12 weeks you can stop taking it forever if you like, and by then you will have paid for 360 capsules at a cost of over £120.
Some very small print at the bottom of the last page says, ‘This product is not intended to diagnose, treat, cure, or prevent any disease.’
In which case, what is it about? Isn’t it funny how our huge multinational pharma corporations can’t come up with a simple answer? They are clearly missing something.
Why go there: to draw your own conclusions.
Downside: no need to spell it out.
Information from: Please click here
Dr Barnard is a former GP in Fareham, Hampshire
Website of the week
This website contains rather more information than most of my usual selections. I know how busy GPs are and that once the surgery door has closed on the last patient their appetite for absorbing more information may be blunted, but these pages are worth the effort.
The pathophysiology of hypertension may not sound the sexiest topic around, but understanding how and why raised BP occurs is essential to understanding what comes next.
What makes this six-page PDF (you only need read five of them) so acceptable is the excellent graphs, tables and diagrams that break up the text and emphasise the important points. Endothelial dysfunction, the role of the autonomic nervous system, genetic factors, insulin sensitivity, intrauterine influences, diastolic dysfunction — it’s all here.
Why go there: all you need to know.
Downside: you have to concentrate.
Information from: BMJ