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Clinical · Comorbidities · continued

Hypertension improvement and when medication needs revisiting — a second dataset posts 91–120

This is a continuation of a long topic, addressed by post number rather than by page. Start at post 1.

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MakinenTL2Member24 Oct 2024#91
m.kjaer, post #31: Hypertension improvement is one of those subjects where the general answer and the answer for a specific case diverge, and the thread will go in circles until someone says which one is being asked for. Go to post

Offering a way to settle Hypertension improvement rather than another opinion about it. Two measurements, taken the same way, a fortnight apart. If the difference is within the noise, the question was not answerable at this precision.

3 likes in reply to #31 21mo
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z.vogelTL224 Oct 2024#92
PWendelboe, post #11: Post #9 put the caveat in the right place and I want to underline it. A history of pancreatitis appears in the cautions for this class and the decision around it is one that needs a clinician who knows the history. Go to post

Post #89 answers the question as asked. The question underneath it is different.

If you are new and reading this thread for the answer to Hypertension improvement: the answer is conditional, the conditions are in the third reply, and the rest of the thread is worth skipping.

0 likes in reply to #11 21mo
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WoodhouseTL2Member24 Oct 2024#93

The practical value of this subcategory is helping somebody frame the question they take to an appointment, and that is worth being explicit about.

32 likes 21mo
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f.espinozaTL224 Oct 2024#94

Something worth flagging about Hypertension improvement: the strongest-sounding claims in this thread are the ones with no source attached, which is the usual pattern and not a coincidence.

16 likes 21mo
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gradient_fileTL2Member24 Oct 2024#95
r.bruun, post #73: Where two conditions pull in opposite directions, that is a clinical judgement rather than a lookup, and it is the kind of question a forum answers worst. I have changed my mind on this once already, so take it as current rather than settled. Go to post

Useful. I had the fact and not the reason, which turns out to be the important half.

6 likes in reply to #73 21mo
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s.kravchenkoTL224 Oct 2024#96
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cohort_notesTL2Member25 Oct 2024#97

The documentation on Hypertension improvement is better than this thread and I say that as someone who has posted in the thread.

0 likes 21mo
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z.adeyemiTL225 Oct 2024#98

The arithmetic on Hypertension improvement is the easy part and it is where the errors are, which is an uncomfortable combination. Show your working and someone will catch it.

23 likes 21mo
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RidgewayTL3Regular25 Oct 2024#99

Answering the question post #97 raises rather than the one it answers.

Gastrointestinal conditions interact with a mechanism that slows gastric emptying in ways that are plausible and largely unstudied.

0 likes 21mo
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an.kirchnerTL225 Oct 2024#100
a.vermeulen, post #65: The practical value of this subcategory is helping somebody frame the question they take to an appointment, and that is worth being explicit about. The interesting part of this is the exception, and I do not understand the exception. Go to post

Hypertension improvement has a well-known answer and a correct answer, and the interesting work is establishing that they are the same. Nobody has done that here yet.

33 likes in reply to #65 21mo
BW
bac_waterTL2Regular25 Oct 2024#101
Birkeland, post #83: Where the honest answer is "nobody knows", giving it plainly is more useful than a confident synthesis of mechanism and anecdote. Go to post

This settles it for me, at least until somebody posts a reason it should not.

0 likes in reply to #83 21mo
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i.guerreroTL225 Oct 2024#102

Where I would push back on the Hypertension improvement consensus is the confidence, not the direction. The direction looks right. The confidence is borrowed.

25 likes 21mo
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d.szymanskiTL3Wiki editor26 Oct 2024 · edited#103

Post #102 and I disagree about the size of the effect, not about the direction.

Post-authorisation safety studies are the place where under-studied populations eventually appear, and they are public.

Adding a source would improve this post and I do not have one to hand.

11 likes 21mo
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s.zamoraTL226 Oct 2024#104

Hypertension improvement looks different depending on whether you are reading the primary literature or the summaries of it, and the difference is not in our favour.

3 likes 21mo
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e.ferreiraTL3Regular26 Oct 2024#105
z.adeyemi, post #98: The arithmetic on Hypertension improvement is the easy part and it is where the errors are, which is an uncomfortable combination. Show your working and someone will catch it. Go to post

I would keep Hypertension improvement and the decision it usually gets used for separate in this thread. They are related and they are not the same question, and merging them is why the last one went badly.

0 likes in reply to #98 21mo
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t.duarteTL226 Oct 2024#106

Where two conditions pull in opposite directions, that is a clinical judgement rather than a lookup, and it is the kind of question a forum answers worst.

33 likes 21mo
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titration_diaryTL3Regular26 Oct 2024#107

Worth separating two things that post #105 runs together.

The practical version of Hypertension improvement is three sentences long. The rigorous version is three pages and reaches the same conclusion with the conditions attached.

17 likes 21mo
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a.jansenTL226 Oct 2024#108

This follows post #105 rather than contradicting it.

Two questions I would want answered before drawing anything from the Hypertension improvement data above: how were the cases selected, and what happened to the ones that dropped out.

7 likes 21mo
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n.rowntreeTL3Regular26 Oct 2024#109

Post #105 describes the usual case. This is about the unusual one.

Where somebody is on several medicines, the interaction question and the comorbidity question are entangled and both belong with a pharmacist.

If that reads as pedantic, it is, and it has saved me twice.

1 like 21mo
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r.bakkenTL227 Oct 2024 · edited#110

The strongest argument against my own position on Hypertension improvement, stated as well as I can state it, since nobody else has yet.

0 likes 21mo
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b.nilsenTL227 Oct 2024#111
t.duarte, post #106: Where two conditions pull in opposite directions, that is a clinical judgement rather than a lookup, and it is the kind of question a forum answers worst. Go to post

The question underneath Hypertension improvement is usually "how would I tell?" rather than "what is true?", and that one has a method attached to it.

Write down what you would expect to see under each hypothesis before you collect anything. If they predict the same observation, collecting it will not help.

0 likes in reply to #106 21mo
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s.dziedzicTL227 Oct 2024#112
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d.barrosTL227 Oct 2024 · edited#113

This follows post #111 rather than contradicting it.

On Hypertension improvement: the maintained page in the documentation commons covers the general case with citations and a review date, which is more reliable than any reply here including this one.

12 likes 21mo
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n.petrovTL227 Oct 2024#114

Worth separating two things that post #110 runs together.

Answering the Hypertension improvement question as asked, then the question I think is meant. As asked: yes, with the qualification below. As meant: it depends on how the first measurement was taken.

26 likes 21mo
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t.vasquezTL4 Moderator27 Oct 2024#115
g.pemberton_uk, post #7: I would put moderate confidence on the mainstream reading of Hypertension improvement and no more. That is not scepticism for its own sake; it is where the sourcing actually stops. Go to post

Confirming post #113 from a second method, which matters more than confirming it from a second person.

Bariatric surgery history: altered anatomy after surgery affects absorption. That matters for oral medications and for reconstituted solutions. Discussing specific medications and doses with a clinician familiar with bariatric surgery is prudent.

Worth saying I have only my own numbers here, and n is small.

1 like in reply to #7 21mo
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n.laurentTL227 Oct 2024#116

Adding the boring version of Hypertension improvement, because the interesting version keeps getting posted and the boring one is usually right.

Check the ordinary explanations, in order, and stop when one of them accounts for what you are seeing. Most of the time the second one does.

7 likes 21mo
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so.cardosoTL228 Oct 2024#117

The confident answers on Hypertension improvement and the well-sourced answers are not the same answers, which is the most useful thing I have learned reading this category.

18 likes 21mo
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va.baptistaTL228 Oct 2024#118

On post #114 — agreed on the reasoning, with one qualification.

Eating-disorder history is raised here regularly and is the case where the guidance most consistently says the decision needs specialist input.

Stating my assumptions rather than smuggling them in.

0 likes 21mo
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impurity_tableTL3Analytical chemist28 Oct 2024#119
e.ferreira, post #89: Post #88 answers the question as asked. The question underneath it is different. On Hypertension improvement the community has more anecdote than the confidence in this thread implies, and I include my own contribution in that. Go to post

Hypertension improvement is well covered in the tag pages, and the older discussions are better than the recent ones because they were argued out properly. Worth twenty minutes before adding to this one.

4 likes in reply to #89 21mo
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j.moreauTL228 Oct 2024#120
n.laurent, post #116: Adding the boring version of Hypertension improvement, because the interesting version keeps getting posted and the boring one is usually right. Check the ordinary explanations, in order, and stop when one of them accounts for what you are seeing. Most of the time the second one does. Go to post

No notes. Posting so the count is not one.

12 likes in reply to #116 21mo