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June 1984

Diuretic Regimens in Essential Hypertension

Author Affiliations

Quincy, Ill

Arch Intern Med. 1984;144(6):1309-1313. doi:10.1001/archinte.1984.00350180259044

To the Editor.  —The article, "Diuretic Regimens in Essential Hypertension," by Licht et al1 in the September Archives was quite interesting but was poorly conceived and contained erroneous conclusions. The ultimate conclusion of the authors was that "Furosemide appears to be the most cost-effective alternative in patients with hypertension in whom intolerable side effects or hypokalemia develops while taking hydrochlorothiazide."While I applaud the authors for addressing a very common and widespread problem such as hypertension and giving a sound clinical and fiscal answer to this problem, I hardly think that their approach was correct. As best as I could tell from reading their article, there was no comment regarding baseline BP measurements in any of the innumerable groups that they examined. They have shown, for example, that when one compares 50 mg/day of hydrochlorothiazide with 40 mg/day of furosemide (Lasix), the BP is absolutely equal in both groups,

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