Author Affiliations: Center for Clinical Management Research, Department of Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, and Department of Internal Medicine and Michigan Diabetes Research and Training Center, University of Michigan, Ann Arbor.
We appreciate Dr Rosansky's comments and observations regarding the potential harms related to overtreatment of hypertension. We agree that guidelines should address not only when to treat blood pressure aggressively, but also when to deintensify treatment. We also agree that examining longitudinal outcomes related to potential blood pressure overtreatment would be an important contribution to the literature and to clinical care. Although we will be proposing to conduct such an analysis, we also recognize that it will require advanced statistical methods to adjust for confounding because patients who are overtreated likely differ in important ways from those who are not.
Kerr EA, Hofer TP. Is Hypertension Overtreatment a Silent Epidemic?—Reply. Arch Intern Med. 2012;172(22):1769-1770. doi:10.1001/2013.jamainternmed.317