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How Aggressive Should Your Treatment Be?


These days, a lot of people want to be part of the decision-making when it comes to what kinds of heart treatment to have. Doctors and other healthcare providers know that people who take an active role in their own healthcare are usually better informed about their treatment and condition and more likely to stick with treatment plans. That’s why it’s become so common to encourage patients to think of themselves as a member of their own healthcare team.

Sometimes, it can feel a little bit scary to know that, basically, the final word is up to you. Your doctor can give you all kinds of advice, but you do have the final say. You might feel like you don’t want to go along with the doctor’s advice, especially if the advice is to have an invasive procedure, such as balloon angioplasty. Most people who have this procedure say it was a lot easier than they expected, but it’s not exactly something you look forward to. When it gets down to it, you know that you are the one making the decision to have the angioplasty or not, and deciding not to may be tempting.

Even taking medication every day can seem aggressive to some people. They might think they’d rather try to manage high cholesterol, for example, with diet and exercise instead of taking pills every day, even if medication is what the doctor recommended. The same can be true of high blood pressure. People with this condition, who usually have no symptoms, sometimes resist taking drugs.

So what do you do when your doctor recommends a specific treatment, but you feel as if you’d rather do something less aggressive?

Established guidelines help in decision-making
You need to know that as a rule, doctors make decisions based on clearly defined clinical guidelines. If studies show that aggressive treatment for a specific condition is most likely to have a better outcome, it’s pretty certain your doctor is going to recommend the aggressive treatment for you.

For example, a recent study in the Journal of the American Medical Association showed that people with unstable angina who had more invasive treatment (which included cardiac catheterization) experienced fewer “cardiac events” at six months than people who had more conservative treatment. Other studies have shown that more people than previously thought should be taking statin medications to control cholesterol.

It’s studies like these that help create treatment guidelines for doctors.

Ask questions!
If your doctor tells you that angioplasty is probably the best option for you, ask why. The same goes for bypass surgery, drug treatment and any other treatment regimen. There’s nothing wrong with asking about it. There are so many variables—your age, your specific condition, your health status, etc.—that affect that decision. There’s no reason why you should automatically understand all the ins and outs of your condition and treatment. 

There’s nothing worse than that nagging feeling that your treatment may not be the right one. So sit down with your doctor and ask for a clear explanation. And keep asking until you feel satisfied that you understand. You need to feel good about your decisions, and getting all the information available is essential.

American Heart Association; Journal of the American Medical Association, 16 October 2002;
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