Hypertension in Pakistan

摘要

I am concerned about this long letter.1 I find it odd and I do not understand why it was accepted for publication. There are two reasons for this concern. Firstly, I find it simplistic in its acceptance of the usefulness of screening for a single risk factor (hypertension) and secondly, I am suspicious of the authors' motives in writing.I have lived and worked for a number of years in Pakistan, and have ongoing connections with the country. Part of my role was in diabetes management, but I very rapidly became disillusioned with regard to treatment recommendations that are based on a developed country model. On my desktop I have, with the permission of Cambridge University (http://www.dtu.ox.ac.uk/Outcomesmode I), the UKPDS Outcomes Model programme that was acquired in order to do some research to prove that which I already know. We all do really. That is, for the vast majority of the population, the recommendation to buy expensive pharmaceutical preparations over many years in order to, largely theoretically, save a few months of life or morbidity, does not take into consideration informed consent.