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Editor's Correspondence
September 18, 2006

It Is Time to Stop Comparing Blood Pressure–Lowering Drugs With Placebo—Reply

Arch Intern Med. 2006;166(16):1786-1787. doi:10.1001/archinte.166.16.1786-b

In reply

We are in agreement with Fuchs in that blood pressure–lowering drugs should not be tested against placebo in patients with a clear indication for blood pressure reduction.

However, this is not the case with the PREAMI population.1 The PREAMI study enrolled elderly post–myocardial infarction patients with preserved left ventricular function (59%) and normal blood pressure (125/74 mm Hg). In 1998, when the PREAMI study started, there was no evidence of the benefits of ACE inhibition in this important subset of patients at higher risk for cardiovascular morbidity and mortality.