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March 18, 1983

The Multiple Risk Factor Intervention Trial

Author Affiliations

Veterans Administration Medical Center Livermore, Calif

JAMA. 1983;249(11):1436-1437. doi:10.1001/jama.1983.03330350017012

To the Editor.—  In the article entitled "Multiple Risk Factor Intervention Trial" in the Sept 24 issue of The Journal, it was reported that men with mild hypertension treated with thiazide diuretics had a higher death rate because of CHD than patients in the UC group, despite the fact that BPs were kept lower in the SI group. This finding has aroused considerable surprise and concern.I would like to call attention to a couple of previously published studies that also indicate a possible myocardial infarct mortality-promoting effect of therapy with thiazide diuretics. In 1978, Jones et al,1 in a retrospective study of 66 patients who died while being treated for high BP, found that almost half of those who had myocardial infarcts were being treated with benzothiadiazide diuretics. In contrast, of those who died of cerebrovascular accident, only one of 11 women was receiving such diuretics (but five