BMJ  2005;331:1022 (29 October), doi:10.1136/bmj.331.7523.1022-a

Letter

ASCOT: a tale of two treatment regimens

Is ASCOT-BPLA being hyped-up?

The first 150 words of the full text of this article appear below.

EDITOR—McDougall et al discuss whether the small absolute differences in secondary outcomes seen in the ASCOT-BPLA study were attributable to the blood pressure differences achieved.¹ They use the accompanying paper to argue that this was in fact not so.²

However, the editorial that accompanies the ASCOT-BPLA study severely criticises this post-hoc analysis and considers that the 2.7 mm Hg systolic gradient is sufficient to explain the cardiovascular benefit of amlodipine with or without perindopril.^3-4 The authors go as far as saying, "Unfortunately, the companion article in today's Lancet, by Neil Poulter and colleagues, weakens the key message that in hypertensive patients it is the lowering of blood pressure that produces most of the benefit, and thereby opens the door for possible misinterpretation, or even misuse of post-hoc results by drug marketers." This is indeed happening and probably keeping the Association of the British Pharmaceutical Industry busy dealing . . . [Full text of this article]

Prescribing and Clinical Effectiveness, Chesterfield Primary Care Trust, Chesterfield S41 7PF peter.burrill@chesterfieldpct.nhs.uk

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