ALLHAT


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AcronymDefinition
ALLHATAntihypertensive and Lipid-Lowering Treatment To Prevent Heart Attack Trial
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The ALLHAT trial, which included more than 42,000 older, high-risk hypertensive patients, compared treatments for the prevention of cardiovascular disease.
9 Atorvastatin 10 mg/d Placebo Mixed * ALLHAT LLT (7) 10,355 35% 4.
In comparative studies prior to this ALLHAT subgroup analysis, ACE inhibitors were thought to be preferable to thiazide diuretics and beta-blockers for patients with obesity (7) or the metabolic syndrome.
In the 42,418-patient ALLHAT, researchers compared four types of antihypertensive drugs: the alpha-blocker doxazosin, the diuretic chlorthalidone, the ACE-inhibitor lisinopril, and the calcium channel blocker amlodipine.
Black, chairman of the department of preventive medicine at Rush University Medical Center, Chicago, said that the ALLHAT findings hold up well to scrutiny: Chlorthalidone was associated with a reduction in certain end points, including heart failure, stroke, and overall cardiovascular events.
The ALLHAT results went a step further, however, and for the first time showed the clinical impact of this muted effect on blood pressure, he said.
The ALLHAT trial, a double-blind RCT of 42,448 high-risk hypertensive patients aged >55 years, compared chlorthalidone (a thiazide-type diuretic) with amlodipine (Norvasc), lisinopril (Prinivil, Zestril), or doxazosin (Cardura).
There was no difference in total mortality or the composite primary outcome in ALLHAT, which underscores a non-blood pressure-related benefit of ACE inhibitor therapy.
We know from the ALLHAT [Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial] data and other studies that even very small changes in blood pressure--2-3 mm Hg systolic--can make a huge difference.
Han BH, Sutin D, Williamson JD, et al, for the ALLHAT Collaborative Research Group.
Statin therapy given as primary prevention to adults aged 65 years and older produced no benefit in any primary or secondary outcomes, according to post-hoc analysis of the ALLHAT trial.