Generated Title: So, Docs Are *Finally* Gonna Listen to the Science? (Don't Hold Your Breath)
Alright, so here we go again. Another study, another "breakthrough," another reason why doctors should be doing something differently. This time it's about blood pressure targets for people with chronic kidney disease (CKD). Apparently, aiming for a lower systolic BP – less than 120 mm Hg – is better than the old standard of less than 140.
Color me shocked.
The "Personalized" Approach: More Like "Personalized" BS
The study, which is being presented at ASN Kidney Week 2025 (mark your calendars, folks!), claims that almost all adults with CKD would benefit from this more intensive approach. They're framing it as some kind of personalized medicine revolution, using "estimated risks and preferences" to justify the lower target. Using estimated risks and preferences to justify intensive BP control in CKD patients
Give me a break. It's still just averages and probabilities being applied to individuals. They even admit that people with more advanced CKD might experience more "treatment-related harms." But hey, at least they also get "larger benefits," right? So everything evens out...somehow?
This whole "shared decision-making" thing Vera from UC Davis is talking about? Yeah, that sounds great in theory. But let's be real: how many patients actually have the time, energy, or knowledge to wade through all this data and make a truly informed decision? And how many doctors are willing to sit down and explain it all in a way that doesn't sound like they're reading from a medical textbook?
I mean, are we really supposed to believe that every doctor is going to suddenly embrace this new approach?
Therapeutic Inertia: The Real Killer
The study authors are worried about "therapeutic inertia" – the tendency of doctors to stick with the status quo, even when new evidence suggests a better course of action. And that's a valid concern, offcourse. But it's also a symptom of a much bigger problem: a healthcare system that's overburdened, understaffed, and incentivized to prioritize efficiency over individualized care.
Doctors are already drowning in paperwork, insurance regulations, and demanding patients. Do we really think they're going to have the bandwidth to meticulously analyze each patient's "estimated risks and preferences" before prescribing a blood pressure medication?
I'm not saying the science is wrong. Maybe this lower target is better for most people with CKD. But the idea that this study is going to magically transform clinical practice is just naive. It's like saying that publishing a recipe for a perfect soufflé is going to turn everyone into a Michelin-starred chef.
It just ain't gonna happen.
And what happens when the next "groundbreaking" study comes along and contradicts this one? Are we just going to flip-flop back and forth, chasing the latest headline? Or will we finally start addressing the systemic issues that prevent us from delivering truly personalized, evidence-based care?
