To the Editor.
—The article by Kaplan, published in the February Archives (1983;143:244-259), discussing when and how to treat mild hypertension presented a well-reasoned approach to a most important subject. However, his conclusions that diuretic and propranolol hydrochloride therapy lowers BP to the same degree and that the propranolol may be preferable in the treatment of white patients requires reassessment in light of the information appearing since his article was published.The Veterans Administration (VA) Cooperative Study Group has recently published the results of a double-blind controlled clinical trial comparing hydrochlorothiazide with propranolol for monotherapy of mild to moderate hypertension1,2; hydrochlorothiazide had greater antihypertensive activity than propranolol, as measured by several different indices of effectiveness. Most importantly, two thirds of the subjects who received hydrochlorothiazide therapy achieved the goal diastolic BP of 90 mm Hg or less, compared with just over half of those subjects who received propranolol therapy.
Burris JF. Mild Hypertension. Arch Intern Med. 1983;143(10):2015. doi:10.1001/archinte.1983.00350100199047