[Why not always diuretics?].
BACKGROUND
New guidelines adopted in Norway for antihypertensive medication implies prescription of a thiazide diuretic as the drug of first choice. The background for the change in the rules for prescription drugs paid for by the National Insurance system with a capped co-payment is a resolution of the Norwegian parliament as part of a budget compromise for 2004. The resolution was supported by results from the ALLHAT study (antihypertensive and lipid-lowering treatment to prevent heart attack trial).


METHODS
ALLHAT was carried out in a group of elderly, high-risk patients with a large proportion of Afro-Americans.


CONCLUSIONS
ALLHAT has important shortcomings with regard to design, results, analysis and interpretation. The trial is considered unfit as a basis for general guidelines on antihypertensive treatment in Norway.
Omvik
Per
P
Hjerteavdelingen, Haukeland Universitetssykehus, 5021 Bergen. per.omvik@med.uib.no
Lund-Johansen
Per
P
D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001581:Benzothiadiazines; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D004232:Diuretics; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D017410:Practice Guidelines as Topic; D049993:Sodium Chloride Symporter Inhibitors / Q000627:therapeutic use*
D000959:Antihypertensive Agents; D001581:Benzothiadiazines; D002121:Calcium Channel Blockers; D004232:Diuretics; D049993:Sodium Chloride Symporter Inhibitors