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August 15, 1980

Preconceptions and Scrutiny

JAMA. 1980;244(7):659. doi:10.1001/jama.1980.03310070013009

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To the Editor.—  No controversy would have arisen over the University Group Diabetes Program results and it is unlikely that the data would have been reexamined had the report confirmed diabetologists' preconceived notion that lowering blood sugar levels of diabetic patients prevents complications and prolongs life.I cannot help but reflect on the controversy that would have arisen had the "Five-Year Findings of the Hypertension Detection and Follow-up Program" (242:2562, 1979) not reported benefits from treating hypertension.Since it did, little attention will be paid to the fact that the first-year mortality of the stepped care group was better than the normal expected rate, there were more diabetics in the referred care group, it contained more who died of noncardiovascular causes, the results were not significantly different in severe hypertensives, and, during the five years of observation, there was no progressive increase in mortality difference between the stepped care and