To the Editor: In their Commentary, Dr Psaty and colleagues1 stated that recent meta-analyses by Carlberg et al2 and Lindholm et al3 confirm their own previous meta-analysis.4 However, their conclusions in that review were that “the available scientific evidence provides strong support for the current national guidelines, which recommend diuretics and β-blockers as first-line agents . . . .” In contrast, Carlberg et al2 concluded that “our results cast doubts on atenolol as a suitable drug for hypertensive patients.” Lindholm et al3 concluded that “we believe that β-blockers should not remain first choice in the treatment of primary hypertension . . . .”
Messerli FH, Beevers G, Franklin SS, Pickering TG. Clinical Trials in Hypertension. JAMA. 2006;296(12):1463–1465. doi:10.1001/jama.296.12.1463
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