This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Topic Collections  • Aging/ Geriatrics  • Women's Health  • Women's Health, Other  • Prognosis/ Outcomes  • Hypertension  • Alert me on articles by topic  Social Bookmarking   What's this?

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: The study by Dr Wassertheil-Smoller and colleagues¹ investigated cardiovascular outcomes in older women using various combinations of diuretics, -blockers, CCBs, and ACE inhibitors. However, it does not report results of the -blocker plus ACE inhibitor or the -blocker plus CCB combinations. The -blocker plus ACE inhibitor combination has gained attention following the ALLHAT study, which reported higher rates of cardiovascular disease, heart failure, and stroke for patients receiving an ACE inhibitor (lisinopril)². This combination was also found to be ineffective for control of blood pressure when -blocker monotherapy had failed³.

It is likewise important to consider that the combination of diuretic plus CCB is not optimal for control of blood pressure,⁴ and represents a flaw in this study. In contrast, diuretic plus ACE inhibitor, diuretic plus angiotensin receptor blocker, diuretic plus -blocker, diuretic plus central sympathetic inhibitor combinations, as well as CCB plus ACE inhibitor . . . [Full Text of this Article]

Michael Bursztyn, MD
bursz@cc.huji.ac.il
Hypertension Unit
Department of Medicine
Hadassah University Hospital, Mount Scopus
Jerusalem, Israel

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?