BMJ 2011; 342: 665 – 716 (26th March)

We may not have to chase blood pressure control as hard as we thought in patients with CKD (although convincing the QOF authors of that may be difficult).  Once we get BP down below 140/90, there seems to be little evidence of benefit from getting it down any further, according to a systematic review in the Annals of Internal Medicine.  I can see that raising some dilemmas along the lines of both QOF vs. evidence and accepted practice vs. evidence.

And I was interested to note that there appears to be a grain of truth in the old advice to MI patients to refrain from sex – sexual activity, like other forms of physical exertion, does slightly raise the risk of a heart attack (the absolute risk was very low, but that would be an average across all risk levels).  However, regular activity does put a person at less risk for each individual activity, so, if you’re going to have sex, have it often.


About Dr Sarah

I'm a GP with a husband and two young children.
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