And you thought you were healthy

The people of Framingham, Massachusetts enjoying their breakfast

Deciding when to begin treatment for heart disease prevention is a big part of the GP curriculum. Once you start a drug for blood pressure the chances are you'll be on it for the rest of your life. Until you either get sufficiently demented to stop taking them, or just too bored to keep popping pills when you'd rather be down the bowling club chatting up the other octogenerians.

Your GP will almost certainly use the "Framingham risk calculator" to see if you need to take a statin, a blood pressure tablet and an aspirin a day. It is a useful tool. If it came about that you had a heart attack and weren't on a buffet of medicines beforehand, many GPs are afraid they will be sued. So they will tap in your details. If Dr Genesis were 70, didn't smoke (although he's thinking of starting up cigars when he hits 75), wasn't diabetic, had a blood pressure of 140/90 and a cholesterol of 6 he would be a happy man. He would consider himself one of the healthiest 70 year old men in the world.

Think again my friend. For Dr Genesis would be classed as "high risk" by the Framingham calculator. He would have a 20% chance of having a heart attack/stroke/angina/sudden cardiac death in the next 10 years. He would instantly be advised to take an aspirin, a statin, at least one if not two antihypertensives and do more exercise. No cigars for Dr Genesis.

Dr Genesis would have the good sense to gently decline his GP's best efforts. He is a little prone to gastritis so would refuse the aspirin. He enjoys tennis and wouldn't want to risk muscle ache from a statin. He is rather fond of his electrolyte balance and so would eschew a diuretic or ACE inhibitor. He would take his chances and do his best to avoid doctors.

But many do not have Dr Genesis's wily and fox-like cunning brain. They will swallow the medicine because it what they have been told to do. They will think of themselves as ill. What a shame.