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February 21, 1996

Myocardial Infarction Associated With Antihypertensive Drug Therapy

Author Affiliations

Shadyside Hospital Pittsburgh, Pa

JAMA. 1996;275(7):516. doi:10.1001/jama.1996.03530310021015

To the Editor.  —I was disturbed by the obfuscation of the editorial comments of Dr Buring and colleagues.1 To just present a discussion of the degree of clinical certainty to be derived from scientific studies and then to simply conclude that the findings of Dr Psaty and colleagues2 offer no clear and important message squander an opportunity to teach a vital lesson and neglect the importance of this ironic twist in the history of hypertension management.It was exactly the same kind of "miscommunication" of nondefinitive data that disparaged the use of diuretics initially.3 In addition, such noncompelling data, aggressively marketed by the pharmaceutical industry, stimulated the substitution of CCBs and angiotensin-converting enzyme inhibitors for both diuretics and β-blockers, despite the latter two's definite clinical benefits.3,4 If the pen is mightier than the sword, then those who live by its exploitation risk dying by its proper