Diuretics and Coronary Heart Disease

To the Editor.— Holme et al¹ present a subgroup analysis from the Oslo Hypertension Study,² relating coronary events in hypertensive patients with and without ECG abnormalities. These patients were given either a placebo or specific antihypertensive therapy, which included a diuretic in most cases. The authors conclude that in the subgroup of hypertensives with pretreatment abnormal ECGs, the trend toward increased coronary events, which was noted in the Multiple Risk Factor Intervention Trial (MRFIT)³ was also observed in their study. They note, however, that their analysis lacks statistical power because of the small number of men studied and caution that conclusions should be drawn with great care from their data.

Unfortunately, many physicians may not read this article as carefully as they should and may erroneously conclude that the data from MRFIT and the Oslo Study were significant and that the use of diuretics in hypertensive patients