FALLACIES IN THE INTERPRETATION OF THE LARGE-SCALE TRIALS OF TREATMENT OF MILD TO MODERATE HYPERTENSION

Data from large-scale trials of treatment of mild to moderate hypertension are being misinterpreted and unjustifiably extrapolated to general populations. The main errors include acceptance of "entry" pressures as typical in spite of evidence that true blood pressure was much lower, extrapolation of results in low-risk volunteers to the whole population, neglect of treatment given to the most endangered control subjects, and the assumption that the burden of side effects seen in a rigid high-dose trial is typical of that seen when the same or better drugs are used in clinical practice. The health risks of hypertension and the benefits conferred by antihypertensive therapy are being played down unjustifiably on the basis of inappropriate data.