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Leszek Michalewiz, MD; Richard Chambers, MSPH
Ochsner Clinic and Alton Ochsner Medical Foundation New Orleans, La

Tomasz Grodzicki, MD, PhD
Collegium Medicum of Jagiollonian University Wielicka, Cracow, Poland

JAMA. 1997;277(22):1759.

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

To the Editor.

—In their meta-analysis of the effect of antihypertensive therapies on preventing disease end points, such as stroke, coronary heart disease, congestive heart failure, and total and cardiovascular mortality, Dr Psaty and colleagues¹ concluded that the data provide strong support for the use of β-blockers and diuretics as first-line agents. However, after a closer look at their data, these conclusions are not supported by the data in the case of β-blockers.

When calculating the relative risk associated with β-blocker therapy, the authors used 4 studies: (1) Medical Research Council trial of treatment of mild hypertension (MRC)²; (2) Medical Research Council trial of treatment of hypertension in older adults (MRC-O)³; (3) Swedish Trial in Old Patients With Hypertension (STOP-H)⁴; and (4) Coope and Warrender.⁵ By doing so, they glossed over the fact that in STOP-H, two thirds of the patients in the active treatment . . . [Full Text PDF of this Article]

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