Had a patient go for PAP smear from her "primary care Gyne" in Barrington IL. Incidental high blood pressure and cholesterol noted at visit. I suggested first trying diet and lifestyle change with introducing exercise. Upon recheck 2 weeks later doc says with a smirk- "...well how long do you plan on doing this?" [before starting medicine] "Your BMI is normal and since your not overweight, diet and exercise wont work"
WHAT THE F@#$!!!! How dare this "primary care Ob/Gyn" make the suggestion that lifestyle change doesn't work. Guess she didn't read the Lyon Heart Study, The Lifestyle Heart Trial, Framingham Heart Study..... If it wasn't for my patient seeking me out, starting an exercise program (hasn't exercised since high school 35 yrs ago), learning about affordable nutrition (works 2 jobs as health care provider and mom), learning the value of slowing down to notice joy/feel grounded (high speed Internet life).....she would have taken the advise of this well established physician in the Barrington Community and started medications without changing harmful practice.
I teach my UIC medical school students that 80% of a diagnosis can and should be made with history taking. That means prying open a patients life with properly asked questions to find out what has brought her to this point after 50 years of living. Blanket statements of "eat healthier" and "eat more veggies" doesn't work for the average American. In fact the government has increased suggested serving amounts since the old suggestions didn't change overall death rates. The minimum level of blood glucose had to be lowered to call more people "prediabetic" since old threshold levels didn't decrease the diabetes epidemic. The food pyramid had to be changed to the food plate since people found the old idea too hard to follow. The majority of patients placed on hypertensive medicines have not been educated on the basics of the DASH diet which is the first intervention step in treating diagnosed hypertension before medicines are prescribed.
Link to National Institute of Health Info
There is a place for high blood pressure medicines, there is benefit for cholesterol lowering drugs, there is a need for quadruple bypass surgeries. Isn't it cheaper to practice healthy Thinking/Eating/Activity prior to the 10 dollar blood pressure medicine, the 30 dollar statin and the $60,000 bypass?
Food for thought while you take your medicine this morning. Here is my medicine: