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December 7, 1970

Treatment of Hypertension

Author Affiliations

Michigan City, Ind

JAMA. 1970;214(10):1886. doi:10.1001/jama.1970.03180100076019

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To the Editor.—  In the study by a Veterans Administration Cooperative Study Group on the effects of treatment of hypertensives on morbidity (213:1143, 1970), complications associated with coronary artery diseases (CAD) were essentially the same in control and treated groups, whereas patients with stroke and congestive heart failure were benefited. Although the authors selected persons with an average diastolic blood pressure of 104.7 mm Hg it may still have been too high, after reduction, to benefit patients with CAD, since this condition may be caused by a still lower blood pressure.In a survey now in preparation, out of 14 persons with a recent history of CAD, seven had a diastolic blood pressure below 90 mm Hg. Of a total of 34 instances of cardiac morbidity, 14 occurred in patients with diastolic blood pressure below 90 mm Hg. Cardiac injury can apparently occur at diastolic blood pressure levels between