Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial
From Wikipedia, the free encyclopedia
The Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial, also known as ALLHAT, was a randomized, double-blind, active-controlled study comparing at the same time, four different classes of antihypertensive drugs with the rate of coronary heart disease (CHD) events in ‘high-risk’ people with hypertension.[1] Participants were initially randomised to chlorthalidone (diuretic) versus doxazosin (alpha-adrenergic blocker), lisinopril (ACE-inhibitor), and amlodipine (calcium channel blocker).[2][3]
The doxazosin arm was discontinued early on in the trial because of a higher rate of combined cardiovascular events and admissions for heart failure compared with chlorthalidone. The study concluded that major CHD events did not differ between initial use of chlorthalidone versus lisinopril or amlodipine. As a result, the Joint National Committee (7) guidelines of 2003, recommended the cheaper but equally effective diuretics as a first line treatment for hypertension. The study also confirmed the previously held views that ACE inhibitors were less effective in blood pressure control and stroke prevention in men of African and Caribbean descent.[3][4]