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December 3, 2003

The Return on INVEST

Author Affiliations

Author Affiliation: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY.

JAMA. 2003;290(21):2859-2861. doi:10.1001/jama.290.21.2859

A decade ago, practitioners who prescribed antihypertensive therapy, and their patients, were transfixed by a passionate and sometimes unseemly public debate over whether dihydropyridine calcium antagonists (not the verapamil type) were safe.1 Aware that the available scientific data were insufficient, contending parties, although agreeing on little else, were all willing to submit their positions to the test of rigorous clinical trials. The missing data now have been provided.2 Disappointingly, while some concerns about calcium antagonists have been laid to rest, their role in antihypertensive therapy remains controversial. Disputants who had thrived on extrapolation from observational data now disagree about how to interpret and apply the abundance of clinical trial data.

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