Response to Letter by Larsen et al
It is correct that the stated protective effect of Eprosartan over Nitrendipine concerns the composite primary end points. As pointed out in the statistical section of the article, we summed up the number of primary end points and the observation time in each group to be able to calculate an event rate per group. However, because of limited space in the article, we could not state in detail that before we computed any statistical test, we ascertained that event frequencies were not different between the groups by comparing the number of persons with 0, 1, 2 or more end points. Because no heterogeneity was detected, we still believe that the test used to compare the ratio of the 2 event rates and our conclusions are correct.
Larsen et al argue that it would have strengthened the study-conclusion if the design had been double-blind. This question was addressed already in the original article.1 We believe that the PROBE design2 might have been the key to get comparable blood pressure values in both treatment groups, which is the most important aspect to strengthen any conclusion of therapeutic effects in hypertension studies (like the MOSES study).