First-Line Therapy for Hypertension

TO THE EDITOR:

In the recent Update in Cardiology (1), Rapaport draws conclusions from the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA) (2) and recommends that physicians consider “using amlodipine as a first-line antihypertensive in patients with ≥3 other cardiovascular risk factors.” This should be interpreted carefully. The ASCOT-BPLA investigators found no difference in the study's primary outcome and observed the reported benefits in …