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November 3, 1989, Vol 262, No. 17 >
ARTICLE | November 3, 1989

The Pressor Effect of Phenylpropanolamine-Reply

George L. Blackburn, MD, PhD; Philip T. Lavin, PhD; Nawfal Istfan, MD, PhD; John P. Morgan, MD; Rudolf Noble, MD, PhD; Frank R. Funderbank, MA
JAMA. 1989;262(17):2387. doi:10.1001/jama.1989.03430170046022.
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In Reply. —  The argument by Drs Pentel and O'Connell states that variability in the response to PPA—especially at higher doses than used in our study— may be associated with a sharp increase in blood pressure in certain individuals. Unfortunately, this conclusion is based on an inadequate sample size. The study by Pentel et al1 used a crossover design involving 10 healthy subjects and reported 3 (30%) of 10 cases with an increase of at least 20 mm Hg in systolic blood pressure for PPA vs placebo. Similarly, O'Connell et al2 found such increases in 4 (40%) of 10 cases. The two-sided 95% confidence intervals for these proportions are 7% to 67% for the study by Pentel et al and 11% to 75% for the study by O'Connell et al. Thus, we are uncertain whether this large variation is a true biologic difference in the response to PPA

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