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Recent Trials in Hypertension
Compelling Science or Commercial Speech?
Bruce M. Psaty, MD, PhD;
Noel S. Weiss, MD, DrPH;
Curt D. Furberg, MD, PhD
JAMA. 2006;295:1704-1706.
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With rare exceptions, hypertension is an asymptomatic risk factor for cardiovascular events such as myocardial infarction, stroke, and heart failure. In contrast to small, short-term trials that evaluate drug effects on level of blood pressure as a surrogate outcome, large, long-term trials provide information about the full range of health risks and benefits associated with antihypertensive treatment. In this Commentary, we review some of the design choices made in the long-term trials of antihypertensive agents, including placebo-controlled trials and the more recent active-comparison trials.
Early trials in hypertension recruited patients with diastolic blood pressure up to 129 mm Hg and compared active treatments, primarily high-dose diuretics, with placebo.1 The results of these trials suggested that antihypertensive treatment reduced the risk of cardiovascular events in patients with high diastolic blood pressure. Subsequent placebo-controlled trials focused on . . . [Full Text of this Article]
Author Affiliations: Cardiovascular Health Research Unit, Departments of Medicine (Dr Psaty), Epidemiology (Drs Psaty and Weiss), and Health Services (Dr Psaty), University of Washington, Seattle; and Wake Forest University School of Medicine, Winston-Salem, NC (Dr Furberg).
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