To the Editor: The study by Dr Wassertheil-Smoller
and colleagues1 investigated cardiovascular
outcomes in older women using various combinations of diuretics, β-blockers,
CCBs, and ACE inhibitors. However, it does not report results of the β-blocker
plus ACE inhibitor or the β-blocker plus CCB combinations. The β-blocker
plus ACE inhibitor combination has gained attention following the ALLHAT study,
which reported higher rates of cardiovascular disease, heart failure, and
stroke for patients receiving an ACE inhibitor (lisinopril)2.
This combination was also found to be ineffective for control of blood pressure
when β-blocker monotherapy had failed3.
Bursztyn M. Cardiovascular Outcomes and Antihypertensive Drug Treatment in Older Women. JAMA. 2005;293(13):1588–1589. doi:10.1001/jama.293.13.1588-b