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Cart before horses on BP

From Dr Fergus Dignan, Brentford, Middlesex

Your story 'QOF skews patient care priorities' (News, 12 January) cites a comparison between the effectiveness of two QOF interventions: ACE inhibitors in heart failure; and hypertension screening and treatment.

You report that the former attracts 6 per cent of QOF money and saves 308 lives per 100,000 patients whereas the latter attracts 45 per cent of QOF cash but saves only 71 lives per 100,000.

This is fallacious as the commonest cause of heart failure (apart from ischaemic heart disease) is hypertension, so by prioritising treatment for BP there will be fewer cases of heart failure in the future.

A case of the horse and cart, I feel!

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