Carlo Favaretti

by VIPAN NIKORE, MD on September 10th, 2012in PHYSICIAN

http://www.kevinmd.com/blog/2012/09/primary-care-missing-link-global-health.html

Sitting on a dusty wooden bench in the rural Sacred Valley in Peru with the Andean mountain range serving as a scenic backdrop, it dawned on me that I was the first physician that my 43-year-old Peruvian patient had ever seen.

After treating his acute diarrhea, I was faced with his elevated but asymptomatic 162/89 blood pressure. I knew he needed treatment, but my concern was whether or not to start him on a blood pressure medicine without follow up. Medications often need to be titrated, and side effects need to be monitored.

What if he was exquisitely sensitive to the anti-hypertensive meds thus causing hypotension and light-headedness? What if he couldn’t afford the medicine in the long run and thus abruptly stopped it and developed rebound hypertension? Why give a month supply of medication if he will not have…

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