care. A flood of health checks, new risk factors, always lower cut-off levels. Soon everyone is healthy than sick - not always for the benefit of patients. But in terms of the pharmaceutical industry.
The doctor reads the numbers from the blood pressure device: "165 100" - and says this "too high". For the 70-year old pensioner Maria Klein, this means that they are now again have to get used to a new pill. It is now already the second blood pressure medication that they should take each day. She asks the doctor how long they the means need. And the answer is - not just in the most optimistic tone: "To finally do something!"
Not so long ago the rule was in blood pressure or "age plus 100." Because Mrs. Klein was still located at their value in the reference range. But times are changing. The limits generally tumble into deeper regions. Not just for older people, it seems increasingly impossible in the "green zone" to remain. In the course of life add up the duration of drugs such as growth rings. "Health is, who has not been investigated properly" - this pun was never realistic. 65-year-old have an average of three chronic diseases today. Also for the younger ones, the safety net is tied ever closer, until finally, almost no one slips through the net.
How dramatic is the situation, recently a Norwegian-Icelandic research team used the example of the European guidelines for the treatment of high blood pressure. These are officially in force since 2007, were created by selected experts from the European Society of Cardiology and hypertension, in many conferences discussed and agreed. One should assume that the consequences of their implementation into daily medical practice would be known and well-being and health of the Europeans to contribute.
All the greater was the surprise when the researchers, the guidelines simply APPLYING once - and to Norway, one of the richest countries in the world with known healthy and long-lived residents. For their experiment, the researchers used a representative model of the Norwegian population, which was fed from the health data of more than 50,000 people.
The result: three out of four northern countries, aged between 20 and 89 years proved to be under the strict guidelines as needed urgently in need of treatment or at least a dense network of regular medical checks. Especially marod showed the age group of 50 - to 64-year-old, where even 99 percent the population of clinical attention needed to oversee the further development of their heart disease risk profile and to conduct in a favorable direction. Now, in addition to blood pressure and other risk factors came into play: First of all the blood fats, blood sugar and obesity. On average, the study would result for each adult, three additional visits per year.
This could cope with this rush, the physicians, should the number of doctors - but the implementation of blood-pressure guidelines - more than doubled. If we add to this the cost of the myriad of laboratory tests, prescriptions and follow-on therapy in the scenario with one, would the Norwegian health system with a blow on the verge of collapse warn the authors of the study - not snub to properly without the blood pressure and heart experts: "We believe such a far-reaching preventive measure to qualify as a science-based are considered, although the consequences of their implementation discussed openly and made transparent. "
Now it seems inconceivable that the authors knew of the EU guidelines are not that far more than half of Europeans has values that go beyond the" normal "defined margin of 120-129 millimeters of mercury (mm Hg) in systolic, or 80 to 84 mmHg in diastolic blood pressure significantly beyond . Go
the clock to give most of the Americans - not only in blood pressure. With the lowering of blood glucose threshold of 110 milligrams per deciliter of blood (mg / dl) to 100 mg / dl, the number of diabetics in the United States in 2003 increased by one stroke from four to 30 million. A year later, and Europe this value. Now, the professional societies already discussing whether a further reduction of the limit to 95 would be appropriate mg / dl.
When cholesterol, it is hardly possible to lower the limit further. Applies here since the mid-eighties, an upper limit of 200 mg / dl. This appears in a highly original light when you know that the average 40-year-old Women in Austria at about 220 mg / dL for men even at 235 mg / dl. At the age of 60 years, the same gender at 245 mg / dl. Only toward the end of life is the value rapidly. Actually, it would therefore be much more rational to fear a drop in cholesterol levels. The thoughts still go in the opposite direction. "Is currently on a reduction to 180 mg / dl talk," says Martin Sprenger, health expert at the Medical University of Graz.
marketing concept is quite loud Sprenger calculus. Money would be earned that is not with drugs for acute needs, such as for a completed after a few days of antibiotics treatment, but for continuous medication that is taken as a residual life daily. "Currently, we hold here at a rate of 70 to 80 percent," said Sprenger. "And the industry is trying to exhaust this market even further." The treatment of severely elevated blood pressure put a great benefit, says Sprenger. However, here the market is relatively small. "The lower the limits are drawn, the greater the market. However, the smaller is the value that brings a drug for the individual. "
are further aid in the conquest of the market, the increasing number of risk factors, certain inflammatory markers bone density and a lack of vitamins, iron and other trace elements. Relatively new on the market is the model of high-priced vaccines that are sold as a kind of insurance policy for a healthy future. A particularly insidious
strategy, says Sprenger, pursued by the new tests, such as on an inherited risk. Who will be the age of 36, he has a genetic greatly increased Alzheimer's disease and prostate cancer risk, so once heard from the group of so-called "worried well" who "worried healthy". These people are offered regular check-ups or preventive drugs. About This bait are many who feel completely healthy, and ready to go into the machinery. "
out Lowering the most limits on the level of cup-itten young people to ensure that the health check or screening test in almost every human being any value in the red content. Following a logic that the sticker is modeled after verification of cars, then tried to bring the readings back to the normal range. First with general recommendations for losing weight, healthy diet or exercise, but rapidly with pharmaceutical aids.
showed more frequently in recent years, however, that the principle of auto repair but not taken as simple can be. Especially among the chronically ill, the deviation is from the norm, a biologically meaningful function. A higher blood pressure allows, for example, to keep the oxygen supply in remote regions in the body upright and provide also the heart sufficiently, if vascular damage is well advanced. An increase in blood pressure also has the purpose to increase the flow rate of the kidney as soon as the internal pollutant inspector seems necessary.
An elevated glucose indicates in any case that more sugar is supplied to the food than the body needs. If the excess sugar or drugs from outside fed insulin "recycled" is, this is done against the original intention of the metabolic regulators. "Imagine a health politicians, who says: 'For a type 2 diabetes, we do not really need medication, but also discipline,'" said Christian Euler, president of the Austrian Association of General Practitioners. "There are good scientific arguments for such a view. But the courage to say so publicly, brings no man. "
In fact the mantra repeated message that it was for the health of a diabetic's most important when he was" well controlled " is increasingly emerging as a promotional message of the industry. A number of studies, namely that in particularly well-controlled diabetic patients with low target values to the risk of hypoglycemia increases, which increases their mortality and dementia risk dramatically. "The doctors have failed as a lawyer of their patients," the Grazer Diabetes expert Thomas Pieber criticized the too late inspection of his trade. "Have you had to question and warn -. And not accept everything compliant, what is presented to them by the industry"
Even with the coming of the 1980 dogma of the "bad" cholesterol that is absorbed from the food and the body poisoned, grows the criticism. How strange was this approach from the outset, the fact that the organism is about 90 percent of the needed cholesterol produces itself and only a small part of the cholesterol contained in food is ever used. The rest is simply eliminated.
is given cholesterol for us simply a matter of survival. It is part of the outer membrane of each cell. Together with proteins, it contributes to the signal input and discharge of substances. From it arise sex hormones, bile acids and the essential vitamin D. Because it was identified as part of the fatty plaque on the inside of damaged vessels, but it was soon the image of pure poison missed. Premature, as many scientists think today. Meanwhile, even discussed whether cholesterol plays a role in the repair of cell damage. Coarse cracks
got the belief system, when the artificial lowering of cholesterol levels was permanently on specific drugs little effect. The best example is the drug ezetimibe, which was originally due to its high cholesterol-lowering effect as a shooting star among the newer drugs. But a study published last November showed that this has no effect on the calcium deposits in the vessels. While the LDL level dropped, these plaques grew even stronger than in the control group with significantly higher Cholesterol levels.
Because cholesterol is a component of animal food, were immediately brought the animal fats into disrepute. This is now increasingly backtracked. Three weeks ago scientists published the Harvard University, the largest-ever review article on the risk of saturated fat in foods, as they are abundant in animal fats like butter or lard, but also in coconut oil or palm oil. To this end, researchers evaluated from 21 large studies with a total of 347 747 participants who were observed over a period of five to 23 years. Results: There is no evidence that saturated Fatty acids, the risk of heart attack or stroke increase.
critics of the health think that something should be less un warned. "For all-clear but feels no one in charge," criticized the Hamburg health scientist Ingrid Mühlhauser, "and fear, unfortunately, a very good manipulation means."
How well this works, it proved the past swine flu pandemic, a worldwide money rain from the manufacturers of drugs and vaccines led. Little did we know but in truth about the biological consequences of this global prevention campaign, illustrates an example from Canada. As there a year ago, the first Wave of swine flu occurred, the doctors made a curious observation: In the schools erkrnakten especially those children who had been previously vaccinated against regular flu. The health authorities reported four studies in order to test this hypothesis. The published results in the previous week confirm the suspicion: indeed had vaccinated people to suffer, on average, twice as likely to swine flu than those who were not vaccinated against regular flu.
How can we explain this connection? How can a vaccine that protects against all other flu viruses that suddenly increase the risk of infection at the "swine flu"? And what effect would such an effect on public recommendation for influenza vaccination? The answer is still pending.
In recent years expanded its offerings for the early detection of disease significantly. This is in the public perception is always associated a better chance of healing. But what if the technology increasingly sophisticated diagnostic equipment precursors or early stages of disease are discovered, which would be healed by themselves - if we had not looked for it?
belongs in what dimension of this problem for us, is a major program, which is currently in the German state of Mecklenburg-Vorpommern. In cooperation the University of Greifswald and Siemens AG are to be moved 4,000 people into the tube of a magnetic resonance imaging (MRI) and carefully screened. A first test run with 200 volunteers have already been completed. Result: To the health of the "Mecklenburg" is ordered miserable.
at only ten percent of the subjects had no pathological changes were discovered, they were therefore "very healthy". Another ten percent were for some additional tests that were necessary to clarify, will also be released as well. But found in the remaining 80 percent, including a brain tumor, narrowed coronary arteries, breast cancer in various preliminary stages and Tumors in the lungs and the abdomen. In this case, all participants who hustled for this study in the MRT, health conscious than average, with no acute symptoms and also relatively young, on average, just 48 years old. What would be expected here until this whole-body screening would be offered for a somewhat older group of the general population. What to do strongly with a method that more than 90 percent of the participants as sick converted
The German example shows that apparently do not manifest any disease as such, but of course disappear. This phenomenon is known so far above all of the programs for early detection of cervical cancer. Here, cells from the cervix are removed, fixed, and then examined in the laboratory. "Arise in younger women are often changes that cause cancer alarm, but almost always heal by itself," says Ahti Anttila, coordinator of the Finnish screening program, compared to profile.
As a consequence, established a minimum age of 30 years. Equally problematic is it if it is examined too often, says Anttila. "We know that a preliminary needs at least ten years to transform itself into an invasive tumor." The consequence of the Finns: the women are examined only every five years. But then with a personal invitation and meticulous quality control, to avoid compromising sloppy removed and the cells in the laboratory can not be interpreted. This even led to the fact that all gynecologists were excluded from the official program because they refused to training.
The swabs are then conducted to the satisfaction of midwives and nurses. This tactic reached Finland by far the world's lowest mortality in cervical cancer in this country it is relatively more than twice as high. In Austria, the practice remains the "wild screening, where women usually have from 18 - are examined - and often in half-year interval. The result is much more useless operations, more cancer therapies and uterine surgery for the most part the lack of quality control. Of an initiative to copy here the successful path of the Finns, is the question. "We know that gynecologists do very difficult to understand these natural processes," says Anttila. "And I have also read that they could compensate for poor quality of investigation in that it examined more often. But this is a mistake. "
In Austria currently working intensively on the first national breast cancer screening program. Also in this area, we are lagging behind other states years. "The also has advantages, "such as project leader Alexander Gollmer of Health Austria GmbH emphasized. "We can hopefully avoid many mistakes that were committed elsewhere." As of January 2011, the first invitation letters to women in the age group between 50 and 69 will be mailed. According to the EU guideline should therefore be reduced breast cancer mortality in the long term by up to 30 percent. "But this is certainly far too optimistic," says Gollmer.
in any case much emphasis on informing women properly and not to conceal the risks. This includes over-treatment of tumors. Many of the discovered plants are still in a preliminary stage. The cancer cells are surrounded with a capsule. No one knows when - and whether - pierces the shell of the tumor. Alone on mammography, the number of these findings in recent years has multiplied. These precursors also usually settle in next to the mammary glands - and are relatively difficult to grasp surgically. That is why many women choose to amputation. To be sure.
This article is in the spring of 2010 the publication of my book "Health comes to the doctor," the news magazine profil been published as cover story.
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