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January 23, 1991

Who Really Determines Your Patients' Prescriptions?

JAMA. 1991;265(4):498-500. doi:10.1001/jama.1991.03460040074033

THE WIDESPREAD publicity and public response to a recent study by Pollare et al,1 who described changes in serum cholesterol levels and glucose metabolism with hydrochlorothiazide compared with an angiotensin converting enzyme inhibitor, captopril, serve to highlight the impact of the media and pharmaceutical industry on the practice of medicine. Patients' reactions were predictable following a front-page story in the New York Times, articles in more than 200 newspapers, and national television coverage. Many patients expressed concerns about their treatment despite the fact that their hypertension may have been well controlled by diuretic therapy for many years. As physicians who have had a long-standing interest and commitment to improving the treatment of hypertension, we are concerned about the manner in which the results of this study were disseminated to the public and to the medical profession. The methods used represent a clear attempt to market a product directly to