Hypertension Treatment How Important Is Consistency of Effect?

There has been a steady stream of large outcomes trials inthe last 20 years that have attempted to answer important questions in cardiovascular disease with the INternational VErapamil SR-Trandolapril (INVEST) Study being one such trial.1 The original intent of the INVEST Study was to compare mortality and morbidity outcomes in patients with hypertension and coronary artery disease treated with a calcium channel blocker (CCB)–based strategy versus a -blocker–based strategy. The premise behind this study was a rather simple one, and at the end of the day, this study showed that a verapamil-based regimen (CCB strategy) and an atenolol-based regimen (-blocker strategy) similarly reduced the primary composite end point of all-cause mor-tality, nonfatal myocardial infarction, or nonfatal stroke.1 Outcome trials are often monumental undertakings with the perception of end-of-study results ranging from th