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Editor's Correspondence |

Headache, Hypertension, and Irbesartan Therapy—Reply

Lennart Hansson, MD; David H. G. Smith, MD; Richard Reeves, MD; Pablo Lapuerta, MD
Arch Intern Med. 2001;161(5):771-778. doi:.
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Benseñor and Lotufo point to several negative references omitted from our recent article on headache and blood pressure1 published in the ARCHIVES, and they suggest that a citation of ours was inappropriate. The study by Stewart2 in 1953 examined subjects with a mean diastolic blood pressure of 136 mm Hg. Stewart was very concerned about splanchnic sympathectomies being performed for symptomatic relief of headache in these subjects. He dissuaded patients from reporting headaches that were not "significant," and he coached them that "of course, everyone gets headaches from time to time." The study by Weiss3 in 1972 had a large sample size, but it was heavily weighted by subjects with normal blood pressures, and it excluded all subjects receiving medication for hypertension. We studied a different group of patients with different methods.

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