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A study is described in which established treatment for hypertension was interrupted by placebo as part of a change to an alternative treatment.
The patients involved were divided into two groups according to their score on the general health questionnaire. All the patients showed an increase in diastolic pressure after the placebo phase of the change-over but the increase was greater for patients with a high score on the general health questionnaire than it was for patients with a low score. For the patients with a high score the diastolic pressure approximated to the level recorded when the diagnosis was first made, but for patients with a low score it was considerably lower than this initial reading.
The implication of this finding for the design of `changeover' studies is discussed.