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The Need to Treat Mild HypertensionMisinterpretation of Results From the Australian Trial
John D. Abernethy, MB, CLB
JAMA. 1986;256(22):3134-3137.
Abstract
Despite the clear-cut result of the Australian Therapeutic Trial in Mild Hypertension, which demonstrated prospectively the benefit of treatment of diastolic blood pressure in the range of 95 to 109 mm Hg, a retrospective analysis that classified subjects by the average diastolic pressure level attained during the trial purported to show an absence of treatment benefit at lower average diastolic pressures and a negative treatment effect at higher levels. However, the method of classification by average attained diastolic pressure introduced substantial selection bias, invalidating the retrospective analysis and rendering as spurious both the deleterious treatment effect and its lack of efficacy at lower diastolic levels.
(JAMA 1986;256:3134-3137)
Author Affiliations
From the Department of Medicine, University of Mississippi Medical Center, Jackson. Dr Abernethy is now with the Division of Public Health, School of Health Sciences, University of Massachusetts, Amherst.
Footnotes
Reprint requests to Division of Public Health, School of Health Sciences, University of Massachusetts, Amherst, MA 01003 (Dr Abernethy).
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