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April 4, 2012

Life Expectancy After Treatment for Systolic Hypertension—Reply

Author Affiliations

Author Affiliations: Cardiovascular Institute, University of Medicine & Dentistry of New Jersey, Robert Wood Johnson Medical School, New Brunswick (Drs Kostis and Cheng) (kostis@umdnj.edu); and Department of Statistics, Rutgers University, Piscataway, New Jersey (Dr Cabrera).

JAMA. 2012;307(13):1368-1369. doi:10.1001/jama.2012.390

In Reply: We never intended to mislead the readers, as can be seen through careful reading of the article. Several items that Dr Coca mentions were included in previous versions of the manuscript and were omitted during the editorial process. We are happy to clarify these issues.

Although life expectancy gain was not nominally statistically significant for all-cause mortality (P = .07), a significant gain in life expectancy was observed for all-cause mortality when patients were analyzed according to whether their systolic blood pressure was controlled to 140 mm Hg. For those controlled at this level at the end of the first year of follow-up, a gain of 333.2 days (95% CI, 186.1-484.8 days) was observed; for those controlled at 2 years of follow-up, 196.3 days (95% CI, 57.2-334.8 days) were gained; and those controlled at the end of the follow-up lived 206.4 days (95% CI, 52.5-355.7 days) longer. However, as Coca states, the primary finding of the study was a gain in life expectancy free from cardiovascular death.

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