DEPARTMENT-OF-VETERANS-AFFAIRS SINGLE-DRUG THERAPY OF HYPERTENSION STUDY - REVISED FIGURES AND NEW DATA

The antihypertensive efficacy of six drugs and placebo was compared in 1292 men with untreated diastolic blood pressure of 95 to 109 mm Hg. The primary end point ''success'' was defined as the patient having ac hieved a diastolic blood pressure of <90 mm Hg at the end of the drug titration period and having maintained a diastolic blood pressure of < 95 mm Hg for 1 year without drug intolerance. The original published s uccess rate data (N Engl J Med 1993;328:914-921) were discovered to be in error due to a computer programming code omission (N Engl J Med 19 94;330:1689). This paper presents corrected graphic figures. The corre cted success rates were generally higher than originally published. Ov erall, diltiazem (72%) was significantly higher than hydrochlorothiazi de (55%), prazosin (54%), captopril (50%), and placebo (31%); clonidin e (62%) and atenolol (60%) were intermediate. There were some changes in the hierarchy of drug response, but important differences in succes s rates according to age by race subgroups remained. Whites responded well to all drug classes, except for lower efficacy of hydrochlorothia zide in younger whites. blacks responded better to diltiazem than othe r agents. In addition, we have analyzed the data using a definition of success based on <90 mm Hg for 1 year. Use of the <90 mm Hg criterion reduced the rate of success, but had only a minor effect on the drug success rate hierarchy. We conclude that single-drug antihypertensive therapy is effective in a majority of stage 1 to 2 diastolic hypertens ive patients; although there are important age-by-race differences in success rates among various drug classes.