0
ARTICLE |

The Cost-effectiveness of Antihypertensive Drugs-Reply FREE

Lee Goldman, MD; Anna N. A. Tosteson, ScD; Lawrence Williams, MSc; Thomas H. Lee, MD; Jonathan T. Edelson, MD; Milton C. Weinstein, PhD
JAMA. 1990;263(21):2889-2889. doi:10.1001/jama.1990.03440210038024
Text Size: A A A
Published online

In Reply. —  Although Dr Kaplan is a distinguished contributor to the field of hypertension, we disagree strongly with his letter. First, our article explicitly addressed all of the major issues that he has raised. Second, his own treatment recommendations, regardless of the consensus on which they may be based, ignore the issue of cost. It is our contention that costs are extremely important in evaluating long-term therapy for an asymptomatic condition and must be considered in making any public health recommendations.We searched the literature for all studies in which placebo controls were used. We recognized the limitations of these studies in terms of the number of patients and the duration of follow-up. However, we also demonstrated convincingly that studies without placebo controls tend to overestimate greatly the antihypertensive effects of medications. We recognized that it is not certain whether blood pressure reductions will reduce coronary deaths, but we

REFERENCES

Hebert PR, Fiebach NH, Eberlein KA, Taylor JO, Hennekens CH.  The community-based randomized trials of pharmacologic treatment of mild-to-moderate hypertension . Am J Epidemiol. 1988;;127:581-590.
Shea S, Cook EF, Kannel WB, Goldman L.  Treatment of hypertension and its effect on cardiovascular risk factors: data from the Framingham Heart Study . Circulation. 1985;;71:22-30.

Figures

Tables

Interactive Graphics

Video

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

Hebert PR, Fiebach NH, Eberlein KA, Taylor JO, Hennekens CH.  The community-based randomized trials of pharmacologic treatment of mild-to-moderate hypertension . Am J Epidemiol. 1988;;127:581-590.
Shea S, Cook EF, Kannel WB, Goldman L.  Treatment of hypertension and its effect on cardiovascular risk factors: data from the Framingham Heart Study . Circulation. 1985;;71:22-30.
CME Course for:


You need to register in order to view this quiz.


To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
To view and print your certificate and access a summary of your CME courses go to My CME.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Response

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.