The Medical Post (April 6):
Dr. Ingrid Martin, team co-ordinator of cardiovascular diseases at WHO in Geneva, told the Medical Post: "WHO takes the concerns and criticisms expressed in the letter seriously. We are planning to develop policy guidelines for hypertension control at the community level to help clarify misunderstandings and to address the issues mentioned."
Ingrid Martin, the team coordinator for cardiovascular disease at the WHO in Geneva, commented: "The recommendations represent the guidelines committee's interpretation of the totality of the available evidence from epidemiological studies and from randomised trials."
Reuters Health (April 1):
Dr. Ingrid Martin, team coordinator for cardiovascular disease at WHO in Geneva, denied that there was insufficient evidence to support revision of the guidelines. She told Reuters Health that the recommendations "...represent the Guidelines Committee's interpretation of the totality of the available evidence from epidemiologic studies and from randomised trials. There is strong evidence from major epidemiologic studies that the relationship between cardiovascular risk and blood pressure is continuous and without a lower threshold."
"The evidence of clear benefit of achieving lower levels of diastolic blood pressure to the range below 85 mmHg in diabetics comes from the UK Prospective Diabetes Study. The evidence also shows that a major determinant of risk reduction conferred by antihypertensives is the level of blood pressure achieved. Another argument from population studies is the evidence that half of all treated patients still have blood pressure elevations above 160/95 and three quarters have levels above 140/90 mm Hg," she said.
Updated April 19, 1999
Hogne.Sandvik@isf.uib.no