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June 1984

Diuretic Regimens in Essential Hypertension-Reply

Arch Intern Med. 1984;144(6):1313. doi:10.1001/archinte.1984.00350180259045

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In Reply.  —Dr Evans indicated that the study was flawed by our not providing baseline BP data in "either one of the cohorts" treated with furosemide 40 mg/day and hydrochlorothiazide 50 mg/day. He has apparently misunderstood the study design, which involved a single cohort for comparing furosemide and hydrochlorothiazide. All patients received both drugs, and observations were paired. The data indicate that stable hypertensive patients treated with hydrochlorothiazide at 50 mg/day or furosemide at 40 mg/day had no change in BP when switched to the alternate diuretic regimen. These observations were subsequently confirmed in a group of patients examined prospectively (J.H.L. and R.J.H., unpublished data, October 1983).It might interest Dr Evans that, prior to our study, we shared his bias that since furosemide has a shorter duration of action, it was probably inferior to hydrochlorothiazide as an antihypertensive agent. The data in our published study simply did not support

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