When Guideline Authors Ignore Their Own Guidelines
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To the Editor:
In an attempt to educate the practicing physician about the new American College of Cardiology/American Heart Association Hypertension Guidelines,1 the New England Journal of Medicine recently published an insightful Clinical Practice Review on initial treatment of hypertension.2
The patient in the vignette was a 56-year-old woman presenting for elevated blood pressure, which was noted at a job site screening. She took naproxen sodium for joint pain (at a dose of 220 mg daily) and had gained 20 lb during the past 5 years, having now a body mass index of 29. On examination, the sitting blood pressure was 162/94 mm Hg in both arms. After a thorough review of pros and cons of various …