Blood Pressure Control by Drug Group in the Antihypertensive and Lipid‐Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) |
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| Authors: | William C. Cushman MD Charles E. Ford PhD Paula T. Einhorn MD MS Jackson T. Wright Jr MD PhD Richard A. Preston MD Barry R. Davis MD PhD Jan N. Basile MD Paul K. Whelton MD MSc Robert J. Weiss MD Arnaud Bastien MD Donald L. Courtney MD Bruce P. Hamilton MD Kent Kirchner MD Gail T. Louis RN Tamrat M. Retta MD PhD Donald G. Vidt MD ALLHAT Collaborative Research Group |
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| Affiliation: | 1. From the Veterans Affairs Medical Center, Memphis, TN;2. The University of Texas Health Science Center at Houston School of Public Health, Houston, TX;3. National Heart, Lung, and Blood Institute, Bethesda, MD;4. General Clinical Research Center, University Hospitals of Cleveland, Cleveland, OH;5. Veterans Affairs Medical Center, Miami, FL;6. Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC;7. Loyola University Health System and Medical Center, Maywood, IL;8. Androscoggin Cardiology Associates, Auburn, ME;9. Bristol‐Myers Squibb, Princeton, NJ;10. D. D. Eisenhower Veterans Affairs Medical Center, Leavenworth, KS;11. Veterans Affairs Medical Center, Baltimore, MD;12. Veterans Affairs Medical Center, Jackson, MS;13. Tulane University Health Sciences Center, New Orleans, LA;14. Howard University Hypertension and Lipid Clinic, Washington, DC;15. The Cleveland Clinic Foundation, Cleveland, OH |
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| 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. |
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