Abstract
In Reply.— We could not agree more with Drs Moser and Gifford. The reported adverse effect of diuretics for the treatment of mild hypertension in patients with certain minorECG abnormalities needs to be viewed with caution. We also agree that all adequately designed hypertension studies using diuretics have shown a reduction in morbidity and mortality from pressure complications such as stroke, but not from CHD, and that is just the point. The Hypertension Detection and Follow-up Program study 1 that is mentioned cannot help to solve this question because of its lack of an untreated control group. In the Australian study 2 which we believe is the best designed randomized trial in mild hypertension, no beneficial effect of thiazides on the incidence of acute myocardial infarction could be demonstrated: 33 cases of acute myocardial infection were observed in each group. Vague indications of a possible adverse effect on CHD
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