Comparison of Dual Therapies for Lowering Blood Pressure in Black Africans

To the Editor: Ojji et al. (June 20 issue) 1 report that amlodipine plus hydrochlorothiazide effectively lowered blood pressure at 6 months in black patients in sub-Saharan Africa. Many primary care providers are unaware of the association between hydrochlorothiazide use and skin cancer. 2 The Medicines and Healthcare Products Regulatory Agency has reported a dose-dependent risk of lip and skin cancers among patients taking hydrochlorothiazide. 2 Regarding melanoma, 3 413 cases were identified among high users of hydrochlorothiazide (patients who had taken a cumulative dose of ≥50,000 mg of hydrochlorothiazide), yielding an adjusted odds ratio of 1.22 (95% confidence interval [CI], 1.09 to 1.36), . . .