Abstract
<h3>To the Editor.</h3> —In their meta-analysis of the effect of antihypertensive therapies on preventing disease end points, such as stroke, coronary heart disease, congestive heart failure, and total and cardiovascular mortality, Dr Psaty and colleagues<sup>1</sup>concluded that the data provide strong support for the use of β-blockers and diuretics as first-line agents. However, after a closer look at their data, these conclusions are not supported by the data in the case of β-blockers. When calculating the relative risk associated with β-blocker therapy, the authors used 4 studies: (1) Medical Research Council trial of treatment of mild hypertension (MRC)<sup>2</sup>; (2) Medical Research Council trial of treatment of hypertension in older adults (MRC-O)<sup>3</sup>; (3) Swedish Trial in Old Patients With Hypertension (STOP-H)<sup>4</sup>; and (4) Coope and Warrender.<sup>5</sup>By doing so, they glossed over the fact that in STOP-H, two thirds of the patients in the active treatment
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