CRITIQUE OF REPORTS OF SURGICAL AND DIETARY THERAPY IN HYPERTENSION

It seems clear that the complications and mortality of hypertensive vascular disease have not as yet been strikingly decreased, despite the glowing reports of the successful dietary, surgical and other treatments of hypertension. The failure to reduce the complications of hypertension must therefore be due, as some claim, to an inadequate or incorrect utilization of the foregoing treatments by the members of the medical profession or, as others claim, at least in major part due to the weaknesses and therefore failure of the effect of the treatments themselves. My purpose in this paper is to point out a few of the many weaknesses of the studies reported and thereby explain the high incidence of success in the studies, and the high incidence of failures in repeat studies with adequate controls.

The chief reason for the constant arrival and subsequent discard of new treatments for hypertension has been the lack of