Hydrochlorothiazide With or Without Amiloride for Hypertension in the Elderly

To the Editor. —In a recent article by Myers¹published in the June 1987 issue of theArchives, the following points need further clarification. 1. One of the study's objectives was to monitor the effects of increasing doses of hydrochlorothiazide, yet it is unclear from the study design whether both the dose of hydrochlorothiazide and amiloride, or just the hydrochlorothiazide alone, was increased. The author states that patients "were randomly allocated to 12 weeks of increasing doses of hydrochlorothiazide either alone or in combination with amiloride. Tablets contained either hydrochlorothiazide, 25 mg, or hydrochlorothiazide, 25 mg, plus amiloride hydrochloride, 2.5 mg, with the tablets being identical to each other and placebo in both appearance and taste.... If the goal blood pressure (supine diastolic pressure, <90 mm Hg) was not attained by week 8, the dosage for the following four weeks was increased to two tablets daily." Therefore, for patients