To the Editor Some evidence against 尾-blockers¹ has been published in recent years; however, the exclusion of these drugs as initial treatment of uncomplicated hypertension in the report from the panel members appointed to the Eighth Joint National Committee (JNC 8)² is surprising.

First, the evidence against atenolol was presented in only 1 study, the Losartan Intervention for Endpoint Reduction in Hypertension Study (LIFE),³ and the quality of this evidence was classified as weak by the panel. Results from LIFE cannot be extrapolated to the general population because the patients included were a high-risk sample with ventricular hypertrophy by electrocardiography and a high prevalence of diabetes mellitus (13%) and cardiovascular disease (25%). Also, the mean age in LIFE was 66.9 years, and it has been shown that 尾-blockers can be more effective in patients with hypertension who are younger than 60 years.⁴ In other studies that analyzed a general population, the performance of 尾-blockers was similar to that of other drugs or the evidence was not sufficient to draw conclusions.