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Thanks for the discussion on NNT - most illuminating. Just to pick up a point you make as an aside, Rod, (and perhaps spin off another thread):
> Fortunately most CVD risk is
> reversible so one should calculate CVD risk over 5-10 years and decide
> whether treatment over this period is worth the benefits.
So by that you mean that there is no cumulative effect for CVD risk reduction treatment?
For example, lets take two 35 yr old hypertensive smokers. One we treat with anti-hypertensives, achieving good control. The other we "watchfully wait". Both decline our attempts to stop smoking. Neither became symptomatic. At age 45 we start the 2nd on antihypertensive treatment, achieving like control. My understanding is that at this point their future risks (chance of death/MI etc) are identical? Ie 10 years of presumably extra workload on the heart/blood vessels had no effect on the untreated person? And this means the only point of treating the first for 10 years was the risk reduction you achieved over that 10 year period.
Thanks
Gary
_________________________________________________________________________
Dr Gary Jackson, Public Health Physician
South Auckland Health, Private Bag 93311, Otahuhu, Auckland
ph 64-9-276 0044 ext 2512 fax 64-9-276 0191 mobile 025 286 1815
email gjackson@ middlemore.co.nz