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October 21, 1974

Antihypertensive Drugs And Stroke

Author Affiliations

Michigan City, Ind

JAMA. 1974;230(3):374-375. doi:10.1001/jama.1974.03240030016012

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To the Editor.—  The cooperative study, "Effect of Antihypertensive Treatment on Stroke Recurrence" (229:409, 1974) is a milestone since it shows that a fall in blood pressure is not followed by benefits in most patients. It shows also what has long been suspected, that mild hypertension may not be benefited by drug treatment. White men and blacks of both sexes obtained neither cerebral nor cardiovascular benefit; some subgroups (mild hypertensives or elderly black men) may have been at a disadvantage while taking drugs.There were six cases of congestive heart failure in those subjects given placebos, and none in those given drugs. Five failures were among the 35 white women. There was only one instance in four years among the 417 blacks and white men. The authors thought the improvement in congestive heart failure to be the chief benefit from drug use. However, significant cardiovascular benefits from drugs were not