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What's New in Hypertension?-Reply
Kevin A. Pearce, MD, MPH
Bowman Gray School of Medicine Winston-Salem, NC
Arch Fam Med. 1994;3(1):19-20.
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| Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings. |
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In reply
Dr Kerr's reluctance to accept that treatment of mild hypertension with drugs reduces cardiac mortality is fully defensible, although his reluctance to accept that it reduces the risk for myocardial infarction (MI) is less so. Furthermore, his argument rests on his skepticism toward statistics associated with observational studies rather than statistics associated with the clinical trials that I cited.
I agree that we lack direct evidence that the treatment of mild-to-moderate hypertension reduces deaths from coronary heart disease, and I have not said otherwise. One reason for the lack may be the relatively short duration of the major clinical trials. However, the evidence is quite good that such treatment reduces the risk for MI, even in the short run. This point is best demonstrated by the five unconfounded major clinical trials of the treatment of mild hypertension,1-5 included in the meta-analysis by Collins et al,6 to which Dr
. . . [Full Text PDF of this Article]
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