14 FEBRUARY 2025

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How to Treat .

TWO IN THIS ISSUE

Rachel Fieldhouse UPCOMING revisions to hypertension guidelines are likely to contain specific recommendations for patients whose hypertension is uncontrolled despite medication .

Heart Foundation chief medical adviser Professor Garry Jennings says treatment inertia — failure to change therapy despite patients not reaching therapeutic goals — is common for patients with high in-clinic blood pressure readings .

‘ We know treatment needs to be intensified .’

“ Patients say , ‘ I have had a lot of stress at work lately ,’ or , ‘ It was hard to get a park today ; I am sure it will be down the next time I come in .’

“ I have experienced it in my own practice , but we know from many studies that the treatment needs to be intensified .”

Australian research found that only 40 % of patients with blood pressure readings ≥140 / 90mmHg had their treatment changed .

Yet to be published PAGE 4

High-dose oestrogen has ‘ no safety data ’.

Ciara Seccombe and Carmel Sparke A MENOPAUSE conference is under fire from a leading doctor for its controversial headline speaker , who is accused of promoting experimental doses of oestrogen to women .

Dr Louise Newson is a high-profile GP in the UK , with a significant social media following and regular TV appearances , and is often credited with starting the country ’ s so-called ‘ menopause revolution ’.

Next month , she will be one of the main presenters at a Sydney medical conference for doctors called So Hot Right Now : Redefining Menopause .

She will also appear at the Sydney Opera House as part of a presentation for the general public .

Last September , a BBC investigation alleged several women treated at her clinics were being prescribed oestrogen far above the limits recommended by the UK ’ s medicines regulators , without being told it was off-label or warned of the potential risks .

In one case , it was alleged the patient had received 300μg / day of oestrogen — three times the maximum recommended daily dose in the UK .

Professor Susan Davis ( pictured ), an endocrinologist and former president of the Australasian Menopause Society , said Dr Newson advocated “ hiking up the dose ” if a patient was on oestrogen as a patch or gel and the symptoms had not resolved .

“ If you hike up the dose of oestrogen , you have to hike up the dose of progestogen ,” Professor Davis added .

“ But we have no breast cancer safety data for these high doses . “ It is like experimenting on women outside of a clinical trial .”

Following the BBC ’ s investigation , the British Menopause Society , a charity , said it had removed Dr Newson from its list of menopause specialists because “ aspects of her practice ” went against “ established guidance ”.

Dr Newson , in response to Professor Davis ’ concerns , stressed that her approach was to tailor treatments to individual women , who may absorb the hormones differently .

“ It is well established that transdermal absorption of oestradiol can vary significantly between individuals — by as much as 10- to 20-fold ,” she told Australian Doctor .

“ This variation , acknowledged in the International Menopause Society ’ s 2024 White PAGE 3

It is like experimenting on women outside of a clinical trial .

— Professor Susan Davis ( pictured )

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