Reprint requests to Department of Hypertension and Nephrology, The Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH 44106 (Dr Gifford).
THE ISSUE of whether to treat "mild" hypertension is more controversial than the two articles1,2 and one editorial3 that were published in the Jan 21 issue of JAMA would lead the unsuspecting reader to believe. There are many who believe that the evidence favors the use of drug therapy to reduce diastolic BP when it is consistently above 90 mm Hg despite a three- to six-month trial of appropriate nonpharmacologic (eg, dietary) treatment.
This issue is not an inconsequential academic controversy. The lives and well-being of more than 20 million Americans with mild hypertension are at risk. The Hypertension Detection and Follow-up Program (HDFP) data indicate that rigorous treatment of mild hypertension decreases the five-year mortality by 20.3% (from 7.4% in the referred care [RC] group to 5.9% in the stepped care [SC] group [P<.01]).4 Even to concede Dr Pickering's "of or by" dilemma, a simple
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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