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Design
Editorial
This editorial questions the methodological foundations of current community approaches to high blood pressure management based on historical epidemiological studies.
Despite the fact that neither the national Health and Nutrition Examination Survey (HANES),1 the Framingham Studies2 , 3 nor the Veterans Administration Cooperative Study of Antihypertensive Therapy4 , 5 were designed to determine the role of hypotensive therapy in a general population, the current approach to the management of high blood pressure in the community rests largely on their conclusions. In fact, proponents of vigorous therapeutic intervention make their case by mobilizing these independent strains of epidemiologic evidence, one related to prevalence and the other to the impact of hypotensive therapy. Unfortunately, important qualifying methodologic features of the relevant studies are often over-looked, and . . .
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Michael H. Alderman (1977) studied this question.
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