My GP registrar took his MCQ for summative assessment today. He was
practising MCQs from a book and came across a question about
hypotension causing symptoms such as tiredness, nausea fainting etc.
The answer claimed all these symptoms were true and said there were a
couple of references, but did not quote them, so it must be true. When
he asked me about it my first response was that hypotension only
occurs within 200 metres of Rodeo Drive and Sunset Boulevard, like
ideopathic hypoglycaemia, but then I remembered it has a higher
incidence in European countries that practise medicine on an item of
service basis, surely of course coincidental.
A jog through Medlinefor him revealed a paper in Family Practice 11_4_:368 to 374 1994
Dec. _Hypotension...does it make sense in family practice? _ A
comparison of German and British GPs showed that 17pc of all patients
attending German GPs were labelled as hypotensive by their doctors or
by themselves, women 2x men, especially young adults. 25pc were on
medication to raise their BP, the abstract does not say what. Actual
and previous BP levels failed to explain symptoms like tiredness,
dizzyness, headache etc and the feeling was that this represented a
tendency to somatize common problems then give them clever medical
labels. Personally I always felt it had something to do with the side
effects of German sausages.
A much more interesting paper in AORN
Journal May 1986 looks at practical aspects of hypotension and is
called _Medical anti-shock trousers. Nursing implications._ There is
no abstract but I assume this has something to do with keeping German
sausages under control.
Bern
Dr Bernard Bedford
Waterside Health Centre
Beaulieu Road
Hythe, Hampshire, SO45 5WX
email: [log in to unmask]
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