Sacrificing prevention to save primary care

Martin and colleagues take us back to the 1950s with their call for reactive care for symptomatic demand rather than anticipating asymptomatic needs.1 Their “worthwhile” number needed to treat (NNT) of 6 comes from one of the earliest hypertension studies, published in 1967—30% of people in the placebo group died or had a major event compared with 1% of those who received active treatment. Systolic pressure of those who died averaged 198 mmHg; today 180 mmHg is …