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ARTICLE |

Diuretics and Coronary Heart Disease FREE

Marvin MOSER, MD; Ray W. Gifford, Jr, MD
JAMA. 1985;253(8):1123-1123. doi:10.1001/jama.1985.03350320043014
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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

REFERENCES

Holme I, Helgeland A, Hjermann I, et al:  Treatment of mild hypertension with diuretics: The importance of ECG abnormalities in the Oslo Study and in MRFIT . JAMA 1984;;251:1298-1299.
Helgeland A:  Treatment of mild hypertension: A five-year controlled drug trial: The Oslo Study . Am J Med 1980;;69:725.
Multiple Risk Factor Intervention Trial Research Group:  Multiple Risk Factor Intervention Trial: Risk factor changes and mortality results . JAMA 1982;; 248:1465-1477.
Moser M:  Clinical trials and their effect on medical therapy . Am Heart J 1984;;107:616.
Moser M:  Clinical trials, diuretics and the management of mild hypertension . Arch Intern Med 1984;; 144:789.
Hypertension Detection and Follow-up Program:  The effect of treatment on mortality in 'mild' hypertension . N Engl J Med 1982;;307:976.
 The Australian Therapeutic Trial in Mild Hypertension . Lancet 1980;;1:1261.

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Holme I, Helgeland A, Hjermann I, et al:  Treatment of mild hypertension with diuretics: The importance of ECG abnormalities in the Oslo Study and in MRFIT . JAMA 1984;;251:1298-1299.
Helgeland A:  Treatment of mild hypertension: A five-year controlled drug trial: The Oslo Study . Am J Med 1980;;69:725.
Multiple Risk Factor Intervention Trial Research Group:  Multiple Risk Factor Intervention Trial: Risk factor changes and mortality results . JAMA 1982;; 248:1465-1477.
Moser M:  Clinical trials and their effect on medical therapy . Am Heart J 1984;;107:616.
Moser M:  Clinical trials, diuretics and the management of mild hypertension . Arch Intern Med 1984;; 144:789.
Hypertension Detection and Follow-up Program:  The effect of treatment on mortality in 'mild' hypertension . N Engl J Med 1982;;307:976.
 The Australian Therapeutic Trial in Mild Hypertension . Lancet 1980;;1:1261.
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To understand the clinical management of acute heart failure syndromes.
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