The ALLHAT Study
Tóm tắt
The ALLHAT trial (Antihypertensive and Lipid Lowering treatment to prevent Heart Attack Trial) is the largest study ever to focus on the treatment of patients with hypertension and the authors’ conclusions have been widely published in the press. However, only a small part of the information published in the newspapers and magazines has focused on the results obtained by the study and great emphasis has instead been given to interpretations based on secondary endpoints. A similar effect on the primary endpoint (fatal and nonfatal coronary artery disease) was observed with all three of the studied drugs in spite of significantly lower systolic blood pressure in the chlorthalidone group.
Tài liệu tham khảo
The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA 2002 Dec 18; 288 (23): 2981–97
The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. Major outcomes in moderately hypercholesterolemic, hypertensive patients randomized to pravastatin vs usual care: the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT-LLT). JAMA 2002 Dec 18; 288 (23): 2998–3007
The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. Major cardiovascular events in hypertensive patients randomized to doxazosin vs chlorthalidone: the antihypertensive and lipid-lowering treatment to prevent heart attack trial (ALLHAT). ALLHAT Collaborative Research Group. JAMA 2000 Apr 19; 283 (15): 1967–75
Lewington S, Clarke R, Qizilbash N, et al. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 2002 Dec 14; 360(9349): 1903–13
Furberg CD, Psaty BM, Pahor M, et al. Clinical implications of recent findings from the Antihypertensive and Lipid-Lowering treatment to Prevent Heart Attack Trial (ALLHAT) and other studies of hypertension. Ann Intern Med 2001 Dec 18; 135(12): 1074–8
Joint National Committee on Detection, Evaluation and Treatment of High Blood Pressure. The sixth report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. Arch Intern Med 1997 Nov 24; 157 (21): 2413–46
Zanchetti A, Mancia G. The ALLHAT trial: a verdict or a challenge? [letter]. J Hypertens 2003 Feb; 21(2): 223
Pahor M, Psaty BM, Aldermann MH, et al. Health outcomes associated with calcium antagonists compared with other first-line antihypertensive therapies: a meta-analysis of randomised controlled trials. Lancet 2000; 356: 1949–54