Ms Arlington has taken the trouble to research the literature and pose pertinent questions regarding our report on the treatment of mild to moderate hypertension with low-dose captopril. She has, however, confused several very separate questions. The question posed by the Veterans Administration Cooperative Study Group on Antihypertensive Agents was whether low-dose captopril was capable of reducing blood pressure in a cohort of patients with mild to moderate hypertension and whether it might have fewer associated adverse effects than the previously used high doses. Our study clearly answers these questions affirmatively.
The second issue pertains to the level of systolic or diastolic blood pressures above which patients ought to be subjected to drug therapy. By selectively referring to some therapeutic trials and not to others, Ms Arlington concludes that treatment of patients with diastolic blood pressures between 92 and 109 mm Hg was entirely unjustified. However, she has left out
Materson BJ, Freis ED. Captopril vs Mild to Moderate Hypertension-Reply. Arch Intern Med. 1985;145(6):1142. doi:10.1001/archinte.1985.00360060210043