ASCOT: a tale of two treatment regimens: Is ASCOT all it's cracked up to be?

doi:10.1136/bmj.331.7523.1023

BMJ 2005;331:1023 (29 October), doi:10.1136/bmj.331.7523.1023

Letter

ASCOT: a tale of two treatment regimens

Is ASCOT all it's cracked up to be?

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

EDITOR—Am I alone in thinking the ASCOT study fails toanswer the question it was set to answer, and moreover raisessome more?¹ McDougall et al seem sure that it has clearly shownthat the new combination of angiotensin converting enzyme (ACE)inhibitor and calcium antagonist is beneficial compared witha ${beta}$ blocker and thiazide.²

Firstly, did the inclusion criteria bias the study against ${beta}$ blockers? Patients with peripheral vascular disease and microalbuminuriawere included whereas patients with biochemical abnormalitieswere not. This looks as if it might favour ACE inhibitors over ${beta}$ blockers.

Secondly, the study showed no significant difference betweenthe two groups with regard to the primary end points, nor anysignificant difference for secondary end points once blood pressuredifferences between the two groups were allowed for.³ McDougallet al say that all the benefits seen in the patients allocatedto the amlodipine-perindopril regimen were unlikely to . . . [Full text of this article]

James A Cave, general practitioner partner

Downland Practice, Chieveley, Newbury RG20 8UY ectopicmailbox-bmj1@yahoo.co.uk