{"id":323,"date":"2007-08-27T21:12:26","date_gmt":"2007-08-27T20:12:26","guid":{"rendered":"http:\/\/resource.bmj.com\/bmj\/2007\/08\/27\/jama-2229-aug-2007-vol-298\/"},"modified":"2007-08-27T21:12:26","modified_gmt":"2007-08-27T20:12:26","slug":"jama-2229-aug-2007-vol-298","status":"publish","type":"post","link":"https:\/\/stg-blogs.bmj.com\/bmj\/2007\/08\/27\/jama-2229-aug-2007-vol-298\/","title":{"rendered":"JAMA  22\/29 Aug 2007  Vol 298"},"content":{"rendered":"<p>A question for all GP readers \u2013 where do you keep your paediatric sphygmomanometer cuff? Do you know if your practice actually has one?<!--more--> I haven\u2019t checked our premises yet, so you can tell how often I measure blood pressure in children. Adolescents occasionally get it done, usually because they have known renal failure or want oral contraception. Most hypertension in children and adolescents goes undetected, as this <a href=\"http:\/\/jama.ama-assn.org\/cgi\/content\/abstract\/298\/8\/874\">cohort study <\/a>from Ohio confirms: but do we know if it makes any difference whether we detect elevated blood pressure at 10 or at 18?<\/p>\n<p>A useful <a href=\"http:\/\/jama.ama-assn.org\/cgi\/content\/abstract\/298\/8\/902\">review of the management of diabetic retinopathy<\/a>, which fortunately for laser-challenged readers includes a good section on prevention as part of management.\u00a0 Control glycaemia down to an HbA1c of 7.5ish: although theoretically you could try for lower, returns diminish and complications increase. Control blood pressure down to\u2026nobody knows, probably till the patient falls over. Then it\u2019s over to the laser boys, who don\u2019t know quite how early to intervene; but once the retinopathy is severe, pan-retinal treatment (sparing the macula) is definitely the thing. If the jelly of the eye gets bled into repeatedly, it\u2019s best to remove it (vitrectomy). Marvellous what chaps like Lord Darzi can do. If only they would confine themselves to what they know about.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>A question for all GP readers \u2013 where do you keep your paediatric sphygmomanometer cuff? Do you know if your practice actually has one? [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/stg-blogs.bmj.com\/bmj\/2007\/08\/27\/jama-2229-aug-2007-vol-298\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":38363,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[111],"tags":[],"class_list":["post-323","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-richard-lehmans-weekly-review-of-medical-journals"],"jetpack_featured_media_url":"https:\/\/stg-blogs.bmj.com\/bmj\/files\/2017\/02\/richard-lehman.jpg","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/posts\/323","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/comments?post=323"}],"version-history":[{"count":0,"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/posts\/323\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/media\/38363"}],"wp:attachment":[{"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/media?parent=323"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/categories?post=323"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/tags?post=323"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}