Best Medical Therapy (BMT) is a term used in clinical practice to describe the optimal combination of non-surgical (conservative) treatments for a specific medical condition, based on current evidence and guidelines. It typically includes:

Pharmacologic treatment (e.g., antihypertensives, statins, antiplatelet agents)

Lifestyle modifications (e.g., diet, exercise, smoking cessation)

Risk factor control (e.g., blood pressure, cholesterol, diabetes management)

Patient education and adherence strategies

Contextual Example: In the setting of asymptomatic carotid artery stenosis, “best medical therapy” may refer to intensive management with statins, antiplatelets, blood pressure control, and lifestyle changes, instead of proceeding with surgery or stenting unless symptoms develop 1).

Note: BMT evolves as evidence and guidelines are updated. The goal is always maximum clinical benefit with minimal risk, particularly in conditions where intervention may not yet be warranted

1)
Kashiwazaki D, Chida K, Yoshida K, Yamada K, Morioka M, Maruichi K, Hori E, Akioka N, Takagi Y, Moroi J, Miyamoto S, Iwama T, Chin M, Kamiyama K, Wada K, Sakai N, Izumo T, Nishikawa Y, Mase M, Hosoda K, Takizawa K, Kobayashi E, Kubo M, Fujita A, Sugiyama T, Fujimura M, Yoshioka H, Kinouchi H, Kunieda T, Nishimura A, Yoshimura S, Shiokawa Y, Abe H, Kataoka H, Ogasawara K, Uno M, Sasaki M, Kuroda S. Clinical features, radiological findings, and outcome in patients with symptomatic mild carotid stenosis: a MUSIC study. J Neurosurg. 2025 Feb 21;143(1):285-295. doi: 10.3171/2024.10.JNS241185. PMID: 40601988.