ALLHAT: setting the record straight.
The findings of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) have generated worldwide reaction from clinicians and researchers, including a recent commentary in this journal. Such response was expected for a trial of ALLHAT's size and scope, especially since its results challenged some widely held beliefs. This paper reviews key aspects of the ALLHAT design, analyses, findings, and conclusions to provide a perspective on the commentary about the trial's results and implications for clinical practice. Several of the most frequent comments regarding the study's results are addressed, particularly with respect to heart failure and diabetes outcomes. Responses to these comments reinforce the investigators' original conclusion that thiazide-type diuretics should remain the preferred first-step drug class for treating hypertension and should generally be a part of any multidrug regimen.
Davis
Barry R
BR
The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas 77030, USA. bdavis@sph.uth.tmc.edu
Furberg
Curt D
CD
Wright
Jackson T
JT
Cutler
Jeffrey A
JA
Whelton
Paul
P
D000959:Antihypertensive Agents / Q000627:therapeutic use*; D003327:Coronary Disease / Q000517:prevention & control*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic / Q000592:standards*; D012107:Research Design / Q000592:standards
D000959:Antihypertensive Agents; D000960:Hypolipidemic Agents