The article by Manolio et al1 on the trends in drug use for the treatment of hypertension in the United States presents some dubious data and misleading inferences. These include such statements as
An estimated 70% to 80% of the outpatient costs for treating hypertension is the cost of antihypertensive drugs.1(p829) The two references for that figure are from the 1993 report by the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure,2 whose source is a newsletter that gives no data,3 and an article by Stason,4 which does not quote any such estimate. Objective and recent data are available, including actual analyses of the various costs of outpatient treatment of hypertension, which were performed by Hilleman et al5 in Omaha, Neb, and by Sclar et al6 in the state of Washington. Drug costs averaged about 40% in both analyses.
The estimated total amount spent