title: Antihypertensive prescribing practices: impact of the antihypertensive and lipid-lowering treatment to prevent heart attack trial.
abstract: This national study examines the impact of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) on the prescribing of thiazide-type diuretics and other antihypertensive medications for patients with newly diagnosed hypertension. A cross-sectional analysis was conducted using data from a national network of electronic health records for 2 groups with newly diagnosed hypertension and started on antihypertensive medications: one a year before and the other a year after the publication of ALLHAT. The percentage of new hypertensives started on thiazides increased from 29% pre-ALLHAT to 39% post-ALLHAT. An increase was also seen for angiotensin receptor blockers, while prescribing for angiotensin-converting enzyme inhibitors, calcium channel blockers, and beta-blockers declined. There was no significant change in prescriptions for alpha-blockers. Prescriptions for thiazides for patients with newly diagnosed hypertension increased after the publication of ALLHAT. Data from large national trials can have a considerable impact on prescribing practices.
authors.affiliation: Department of Family Medicine, Medical University of South Carolina, 295 Calhoun Street, Charleston, SC 29425, USA. playerm@musc.edu
authors.forename: Marty S
authors.initials: MS
authors.lastname: Player
authors.forename: James M
authors.initials: JM
authors.lastname: Gill
authors.forename: Heather Bittner
authors.initials: HB
authors.lastname: Fagan
authors.forename: Arch G
authors.initials: AG
authors.lastname: Mainous
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000008:administration & dosage / Q000627:therapeutic use; D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000627:therapeutic use; D000328:Adult; D047228:Angiotensin II Type 1 Receptor Blockers / Q000008:administration & dosage / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002121:Calcium Channel Blockers / Q000008:administration & dosage / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D017723:Drug Utilization Review; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications / Q000188:drug therapy; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D000960:Hypolipidemic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000517:prevention & control*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D049993:Sodium Chloride Symporter Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D014481:United States
chemical_list: D000317:Adrenergic alpha-Antagonists; D000319:Adrenergic beta-Antagonists; D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D000960:Hypolipidemic Agents; D049993:Sodium Chloride Symporter Inhibitors