Enforcing New Blood Pressure Guidelines May Lead to Serious Falls

(p. A23) “Under New Guidelines, Millions More Americans Will Need to Lower Blood Pressure.” This is the type of headline that raises my blood pressure to dangerously high levels.
. . .
The new recommendation is principally in response to the results of a large, federally funded study called Sprint that was published in 2015 in The New England Journal of Medicine.
. . .
A blood pressure of 130 in the Sprint study may be equivalent to a blood pressure of 140, even 150, in a busy clinic. A national goal of 130 as measured in actual practice may lead many to be overmedicated — making their blood pressures too low.
. . .
Serious falls are common among older adults. In the real world, will a nationwide target of 130, and the side effects of medication lowering blood pressure, lead to more hip fractures? Ask your doctors. See what they think.
. . .
I suspect many primary-care practitioners will want to ignore this new target. They understand the downsides of the relentless expansion of medical care into the lives of more people. At the same time, I fear many will be coerced into compliance as the health care industry’s middle management translates the 130 target into a measure of physician performance. That will push doctors to meet the target using whatever means necessary — and that usually means more medications.
So focusing on the number 130 not only will involve millions of people but also will involve millions of new prescriptions and millions of dollars. And it will further distract doctors and their patients from activities that aren’t easily measured by numbers, yet are more important to health — real food, regular movement and finding meaning in life. These matter whatever your blood pressure is.

For the full commentary, see:
H. GILBERT WELCH. “Rethinking Blood Pressure Advice.” The New York Times (Thurs., NOV. 16, 2017): A23.
(Note: ellipses added.)
(Note: the online version of the commentary has the date NOV. 15, 2017, and has the title “Don’t Let New Blood Pressure Guidelines Raise Yours.”)

Welch has a book that makes a similar point, though more broadly, to that made in the passages quoted above:
Welch, H. Gilbert. Less Medicine, More Health: 7 Assumptions That Drive Too Much Medical Care. Boston, MA: Beacon Press, 2015.

France’s “Mille-Feuille” Regulations

(p. A1) France has long been known for its open hostility to corporations and its suspicion of personal wealth. Taxes were high, regulations were baffling and “It’s not possible” was the default answer to any question — if a company could even find the right person to ask.
Now, the country is in the midst of a sweeping attempt at national rebranding. Labor laws are being changed to make hiring and firing easier. New legislation has slashed a “wealth tax” that was said to drive millionaires out of the country.
. . .
(p. A5) “When you grow up in France, none of the heroes you learn about are entrepreneurs,” said Brigitte Granville, a professor of economics at Queen Mary University of London, who was raised in France. “When someone gets rich in France, people immediately ask, ‘What did he do to make this money? He must be a nasty person.'”
. . .
Now, a new crop of French leaders, most notably the free market-supporting president, Emmanuel Macron, are vigorously trying to shed this anticapitalist reputation. During his campaign, he visited London, home to as many as 400,000 French expatriates, urging them to return to France and “innovate.”
. . .
France’s economic makeover has inspired some derision outside of the country, too. It has the faint smell of desperation to people like Nicolas Mackel, the chief executive of Luxembourg for Finance, a public-private partnership that promotes the country as a business hub.
. . .
“You’ll accuse me of bashing the French,” he said over tea recently, “but earlier this year, they announced that they would have regulators who speak English. We didn’t need to do that because our regulators already speak English and always have.”
For France, English-speaking government officials would be little more than a promising start. The country has so many bewildering layers of regulations that its system is known, unaffectionately, as mille-feuille, a reference to a densely layered pastry.

For the full story, see:
DAVID SEGAL. “Paris Tries On A Fresh Look: Less Red Tape.” The New York Times (Mon., DEC. 11, 2017): A1 & A5.
(Note: ellipses added.)
(Note: the online version of the story has the date DEC. 10, 2017, and has the title “As Brexit Looms, Paris Tries a Business Makeover.”)

The Dutch Laughed in Their Golden Age

(p. 16) HAARLEM, the Netherlands — If you were asked to quickly close your eyes and conjure a picture of the Dutch Golden Age, you might come up with an image of dour, pale figures clad all in black with stiff white ruffs bracing their necks. But it may be time to update that image.
Jokes, and particularly coarse or bawdy humor, were apparently central to the life and art of the Dutch 17th century, according to a new exhibition at the Frans Hals Museum here, “The Art of Laughter: Humor in the Golden Age” which runs from Nov. 11 through March 18, 2018. The exhibition features about 60 masterpieces from leading artists such as Hals, Rembrandt, Jan Steen, Judith Leyster and Gerard van Honthorst, inspired by comic characters, explicit humor and visual punning — with lots of images of people laughing.
“If we learned anything from the research, it was how incredibly important and how widespread humor was in the Golden Age in Dutch culture, but also in painting,” said Anna Tummers, one of the show’s curators at the museum, in an interview a few weeks before the opening. “The more we worked on it, the more we realized quite how many paintings have a joke as their very core.”
. . .
The type of humor in the pictures breaks down into three categories. More than half make scatological references (in which “human excreta feature prominently,” according to the exhibition catalog) while sexually suggestive images make up much of the rest. In the second category, the jokes often focus on “unbridled lust or unequal love.” The third category is trompe-l’œil images — which are designed to fool the eye — or painted practical jokes, which had been in existence since antiquity but surged during the Dutch Golden Age.
“There are lots of sources about how art lovers and others couldn’t stop laughing when they realized that they were taken in by pictures of for example, a boy sleeping or a maid that someone tried to kiss, but who turned out to be a painting,” Ms. Tummers said.

For the full review, see:
NINA SIEGAL. “Need a Laugh? The Dutch Golden Age Can Help.” The New York Times FINE ARTS & EXHIBITS Section (Sun., OCT. 29, 2017): 16.
(Note: ellipsis added.)
(Note: the online version of the review has the date OCT. 21 [sic], 2017, and has the title “Need a Good Laugh? Check Out Some 17th-Century Dutch Art.” The wording of the online version differs substantially from that in the print version. The passages quoted above, are from the online version.)