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November 27, 1996

Reversal of Left Ventricular Hypertrophy-Reply

Author Affiliations

University of Erlangen-Nuremberg Nuremberg, Germany

JAMA. 1996;276(20):1637. doi:10.1001/jama.1996.03540200023020

In Reply.  —The aim of our meta-analysis was to elucidate clinical determinants for the regression of left ventricular hypertrophy in essential hypertension. Different drug classes were evaluated with respect to their ability to reduce left ventricular mass.1 Since none of the double-blind, randomized, clinical trials compared all drug arms in a single study, we decided to choose treatment arms as units in our metaanalysis. Potential criticisms of this procedure might be that treatment arms of different studies are not comparable and that the "valid n" of our meta-analysis is thereby artificially increased.If 2 or more groups are compared, it is essential that within each group the results are independent. If one ignores an existing positive correlation, the result indeed is an overestimation of statistical precision. However, that was definitely not what we did. Instead, we broke the "matching" of study arms with different treatments, and the meta-analysis is more likely