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August 9, 1993

Hypertension: Steps Forward and Steps Backward

Author Affiliations

White Plains, NY

Cleveland, Ohio

Arch Intern Med. 1993;153(15):1843-1846. doi:10.1001/archinte.1993.00410150133013

Several comments in the recent editorial by Weber and Laragh1 require an answer.

Each of us has served as a chairman of one of the Joint National Committees (JNC) on the Detection, Evaluation, and Treatment of High Blood Pressure, and as a member of the other committees. We can attest to the fact that the reports of these committees are based on available science and not on speculation, theory, or possibilities. The recommendations of the fifth Report of the JNC (JNC V) were made based on available data.2 All of us recognize that the introduction of ACE inhibitors and calcium-channel blockers has made the management of hypertension easier; we have been using these drugs with success for many years. While it is possible that therapy with these agents will reduce mortality and morbidity to as great or even greater extent than diuretics or β blockers, there are no