To the Editor.
—We read with great interest the results of the meta-analysis by Dr Schmieder and colleagues.1 In their "Comment" section, the authors indicated that the Treatment of Mild Hypertension Study (TOMHS)2 was not included in the meta-analysis, among other studies, because it did not fulfill 1 of the 12 inclusion criteria, namely, that the primary goal of the study was to analyze the effects of antihypertensive compounds on left ventricular hypertrophy.We feel that this is a weak reason for exclusion of a study (and possibly other studies) that were randomized, doubleblinded and also placebo-controlled (not an absolute criterion for the meta-analysis). Change in left ventricular mass was 1 of several end points in TOMHS. In fact, a criterion for inclusion in the TOMHS study was an adequate echocardiographic study. The total number of participants in TOMHS in the 4 drug treatment groups corresponding to the
Liebson PR, Grandits G, Grimm RH. Regression of Left Ventricular Hypertrophy. JAMA. 1996;276(7):526-527. doi:10.1001/jama.1996.03540070022017