title: Blood pressure control by drug group in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT).
abstract: Blood pressure (BP) control rates and number of antihypertensive medications were compared (average follow-up, 4.9 years) by randomized groups: chlorthalidone, 12.5-25 mg/d (n=15,255), amlodipine 2.5-10 mg/d (n=9048), or lisinopril 10-40 mg/d (n=9054) in a randomized double-blind hypertension trial. Participants were hypertensives aged 55 or older with additional cardiovascular risk factor(s), recruited from 623 centers. Additional agents from other classes were added as needed to achieve BP control. BP was reduced from 145/83 mm Hg (27% control) to 134/76 mm Hg (chlorthalidone, 68% control), 135/75 mm Hg (amlodipine, 66% control), and 136/76 mm Hg (lisinopril, 61% control) by 5 years; the mean number of drugs prescribed was 1.9, 2.0, and 2.1, respectively. Only 28% (chlorthalidone), 24% (amlodipine), and 24% (lisinopril) were controlled on monotherapy. BP control was achieved in the majority of each randomized group-a greater proportion with chlorthalidone. Over time, providers and patients should expect multidrug therapy to achieve BP <140/90 mm Hg in a majority of patients.
authors.affiliation: From the Veterans Affairs Medical Center, Memphis, TN, USA.
authors.forename: William C
authors.initials: WC
authors.lastname: Cushman
authors.forename: Charles E
authors.initials: CE
authors.lastname: Ford
authors.forename: Paula T
authors.initials: PT
authors.lastname: Einhorn
authors.forename: Jackson T
authors.initials: JT
authors.lastname: Wright
authors.forename: Richard A
authors.initials: RA
authors.lastname: Preston
authors.forename: Barry R
authors.initials: BR
authors.lastname: Davis
authors.forename: Jan N
authors.initials: JN
authors.lastname: Basile
authors.forename: Paul K
authors.initials: PK
authors.lastname: Whelton
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Weiss
authors.forename: Arnaud
authors.initials: A
authors.lastname: Bastien
authors.forename: Donald L
authors.initials: DL
authors.lastname: Courtney
authors.forename: Bruce P
authors.initials: BP
authors.lastname: Hamilton
authors.forename: Kent
authors.initials: K
authors.lastname: Kirchner
authors.forename: Gail T
authors.initials: GT
authors.lastname: Louis
authors.forename: Tamrat M
authors.initials: TM
authors.lastname: Retta
authors.forename: Donald G
authors.initials: DG
authors.lastname: Vidt
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017311:Amlodipine / Q000494:pharmacology / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D002121:Calcium Channel Blockers / Q000494:pharmacology / Q000627:therapeutic use*; D002752:Chlorthalidone / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D004232:Diuretics / Q000494:pharmacology / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D017706:Lisinopril / Q000494:pharmacology / Q000627:therapeutic use; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D004232:Diuretics; D017311:Amlodipine; D017706:Lisinopril; D002752:Chlorthalidone