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Author: Jeremy A. Greene
ISBN : 0801891000
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The second half of the twentieth century witnessed the emergence of a new model of chronic disease—diagnosed on the basis of numerical deviations rather than symptoms and treated on a preventive basis before any overt signs of illness develop—that arose in concert with a set of safe, effective, and highly marketable prescription drugs. In Prescribing by Numbers, physician-historian Jeremy A. Greene examines the mechanisms by which drugs and chronic disease categories define one another within medical research, clinical practice, and pharmaceutical marketing, and he explores how this interaction has profoundly altered the experience, politics, ethics, and economy of health in late-twentieth-century America.
Prescribing by Numbers highlights the complex historical role of pharmaceuticals in the transformation of disease categories. Greene narrates the expanding definition of the three principal cardiovascular risk factors—hypertension, diabetes, and high cholesterol—each intersecting with the career of a particular pharmaceutical agent. Drawing on documents from corporate archives and contemporary pharmaceutical marketing literature in concert with the clinical literature and the records of researchers, clinicians, and public health advocates, Greene produces a fascinating account of the expansion of the pharmaceutical treatment of chronic disease over the past fifty years.
While acknowledging the influence of pharmaceutical marketing on physicians, Greene avoids demonizing drug companies. Rather, his provocative and comprehensive analysis sheds light on the increasing presence of the subjectively healthy but highly medicated individual in the American medical landscape, suggesting how historical analysis can help to address the problems inherent in the program of pharmaceutical prevention.
Direct download links available for Free Download Prescribing by Numbers: Drugs and the Definition of Disease [Paperback]
- Paperback: 336 pages
- Publisher: Johns Hopkins University Press; 1 edition (October 1, 2008)
- Language: English
- ISBN-10: 0801891000
- ISBN-13: 978-0801891007
- Product Dimensions: 0.8 x 5.9 x 8.9 inches
- Shipping Weight: 1.1 pounds (View shipping rates and policies)
Free Download Prescribing by Numbers: Drugs and the Definition of Disease
In 1957 the Fremingham Study identified the main risk factors of coronary heart disease. High blood pressure and high cholesterol were later joined by diabetes as the three main physiological variants believed to be mechanistically connected to heart disease. Reduce your blood pressure, your cholesterol level and your blood sugar, and you are less likely to suffer from a stroke or a coronary artery disease.
Prescribing by Numbers presents selected episodes in the emergence of these three principal cardiovascular risk factors and the careers of three pharmaceutical products whose fates have been inseparable from the conditions they treated. The narratives of these three prescription drugs--Diuril, Orinase, and Mevacor--overlap to provide a unique perspective on the growth of asymptomatic disease categories and the role of the pharmaceutical industry in their emergence.
Diuril represented the first palatable pill for hypertension, and although its history is less well known than the saga of antibiotics, the dramatic emergence of antipsychotic drugs, or the cultural hand-wriging surrounding the minor tranquilizers, the influence of this drug on clinical practice was equally profound. Hypertension became a different disease after Diuril. By making antihypertensive therapy a sweet pill to swallow, Diuril lowered the threshold for the prescription and consumption of hypertensive medications, enlarged the population of potential hypertensive patients in both clinical trials and clinical practice, and contributed to the consolidation of a single threshold for the definition of hypertension.