It’s actually a hard question to answer, so try writing about it.
First of all, the definition of “good” here is difficult, many people will simply define “expensive” as “good”, which in some cases is a rational and cruel approach. The vast majority of people do not consume “expensive drugs” like luxury goods, but rather as a status symbol, saving a little on their medication. How do you choose the right treatment strategy for you?
Assuming a person finds themselves with high blood pressure, what strategies are available?
(1) Anyway, it is only a little higher than normal, if you take the medicine now, it will be useless to take the medicine when your blood pressure is higher in the future, so it is better not to take the medicine first, then look at it. (Strategy: no treatment)
(2) Anyway, it is only a little higher than the normal value, if I take the medicine now, then my blood pressure will be higher in the future, it will not be useless to take the medicine, looking back, it seems that my normal diet is a little salty, a little oily, and less exercise, then I will eat a lighter diet, strengthen the exercise appropriately, and look at it after a while. (Strategy: Lifestyle Adjustment)
(3) A neighbor, Zhang San, said that there is a herb that can be dug into the ground and boiled in water to lower blood pressure / A WeChat public post said that putting something in the foot wash at night can lower blood pressure / There are Indian antihypertensive drugs on sale in the market, which are said to be better than the domestic ones… I’ll try it out (strategy: use a prescription)
(4) The neighbor Li Si also has high blood pressure for many years, according to him, there is a Chinese medicine doctor in the north of the city to see, I went to that Chinese medicine doctor to prescribe some medicine. (Strategy: Chinese medicine treatment)
(5) Anyway, it is only a little higher than the normal value, if you take too good a medicine now, the blood pressure will be even higher in the future, it will be useless to take good medicine, I find some domestic chemicals to take (strategy: domestic chemicals)
(6) If you want to take it, take imported medicine! (Strategy: import of chemicals)
Of course, there are many more scenarios that can be broken down by strategy breakdown, for example, there may also be a large gap between domestically produced chemicals and domestically produced chemicals. These strategies can range from free to costly, but a lot of authoritative information doesn’t tell you which is better. For example, domestic and imported drugs, although sometimes the clinic may subjectively believe that imported drugs are better, but domestic chemical drugs are also government-approved and tested products, many of our drug standards are not less stringent than developed countries. In other words, no official channel will admit that domestic drugs are inferior to imported ones.
In addition, foreign information for our help is also very limited, for us there are 123456 so many strategies, there may be Putian hospital treatment ah and so on, while developed countries 345 are not there, they are the same class of disease treatment drugs not so much.
Medicine does not encourage people to “pick the expensive ones over the right ones”, so it is necessary to evaluate whether the chosen strategy will achieve its purpose.
And our purpose is quite simple: to be safe and effective.
These two principles are such a big topic to discuss that one book probably won’t tell the whole story, and countless scientists and health care industry practitioners struggle with them every day, so here’s just a quick note.
Safety is a prerequisite, and unsafe strategies, even if effective, should be discarded, such as the “Indian antihypertensive” mentioned above – of course, there is reason to believe that it has nothing to do with India – suspected to be in fact a large dose of diuretics, after taking them, the urine volume increased greatly and blood pressure decreased, but after years of taking them, the side effects began to show: electrolyte disorders, kidney function damage, and even kidney failure. And diuretics used routinely to lower blood pressure are not prone to produce such powerful side effects so quickly – so presumably in unusually large doses. In the same way, there are “Thai gout pills” and so on, which presumably contain large doses of hormones and relieve the pain immediately after consumption, but long-term consumption is associated with various hormonal side effects: centripetal obesity, gastrointestinal bleeding (which can kill people), drug-borne Cushing’s syndrome, etc. Therefore, when a “drug” of dubious origin has good efficacy, there is actually reason to doubt its safety, because regular large hospitals tend to diagnose and then treat it clearly, and will not give a drug that masks the symptoms, but will also consider the safety and not give such a strong drug.
For antihypertensive drugs, of course, the use of blood pressure attainment, or cardiovascular complication rates, or mortality as indicators of effectiveness, there are still various medical opinions. But if an antihypertensive strategy cannot make the blood pressure reach the standard, then it is necessary to doubt its effectiveness, such as the strategy 2 mentioned above, some people have high blood pressure, through a change in lifestyle, blood pressure has come down, then there is no need to take medication, but some people just change their lifestyle, then fall into a kind of self-soothing satisfaction, every day silently chanting “How hard do I try to lower blood pressure, do you make?” If, in fact, the blood pressure is far from the mark, then the strategy is faulty.
In addition, scientific monitoring is also an important part of the effectiveness of the examination, such as many diabetic patients through the use of insulin in the evening, or less dinner, so that the next morning fasting blood sugar “standard”, they think their blood sugar has been well controlled, and then will feast during the day, in fact, the daytime blood sugar has long since burst. That’s why people who say their blood glucose is well controlled should ask them what time they normally measure their blood glucose. Blood pressure is also the same, get up in the morning and take a short-acting antihypertensive by mouth once, then take a normal blood pressure measurement at 9:00 a.m., and you’ll be resting on your feet, not knowing that the effect of a short-acting antihypertensive is usually only a few hours. This self-paralysing “effectiveness” can also have serious consequences over time.
If both strategies are safe and effective, it’s not a bad idea to choose the cheaper one, given the family’s financial situation.
In summary, there are a few points that require special attention with regard to the choice of treatment strategies, especially for patients with chronic diseases.
1. Lifestyle adjustments are necessary for the control of most chronic diseases.
2. Choose medicines from formal sources, avoid visiting doctors who are not qualified to practice medicine, buy medicines from “markets” that are not qualified to sell medicines, etc.
3. The control of chronic diseases is not permanent; it is a matter of persistence.
4. Scientific and regular monitoring can inform the control of chronic diseases and provide a basis for optimizing or adjusting control strategies.