ALLHAT (Antihypertensive and Lipid Lowering to prevent Heart Attack Trial) is a large-scale randomized study sponsored by the US Department of Health dedicated to treating patients with hypertension and testing new antihypertensive drugs. The study involved placebo and 4 drugs of different classes - amlodipine , lisinopril , chlortalidone and doxazosin .
In general, it was found that the new drugs do not have significant advantages over the old ones and are much cheaper, and doxazosin has significant disadvantages (its test was terminated early due to high mortality and morbidity). Also, during the results of various studies, it was noted that the thiazide-like diuretic chlortalidone is more effective than other drugs.
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Study Goal
The aim of this study was to determine whether new blood pressure normalizing drugs, such as the ACE inhibitor lisinopril , calcium antagonist amlodipine, and alpha receptor blocker doxazosin , can also help better or better than the older and cheaper drug thiazide-like chlortalidone diazuretic in preventing fatal heart diseases and non-fatal heart attacks.
In another randomized part of the study, ALLHAT examined approximately 20,000 patients for statin therapy ( pravastatin ) with slightly elevated cholesterol , and also studied the mortality rate compared with patients who were treated with standard treatment methods.
Study Participants
The study participants were men and women under the age of 55 with arterial hypertension (I or II stages) and one additional cardiovascular risk factor, such as myocardial infarction , left ventricle (in the left ventricle), hypertrophy , type 2 diabetes mellitus , current nicotine abuse, low HDL cholesterol below 35 mg / dl or other atherosclerotic diseases . Patients who have already been treated for heart failure in the hospital or had an ejection fraction less than 35 percent of the left ventricle were excluded from participation.
Literature
- Davis BR, Cutler JA, Gordon DJ, et al. Rationale and design for the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). Am J Hypertens. 1996; 9: 342-360. ( Link )
- The ALLHAT study group. Major Outcomes in High-Risk Hypertensive Patients Randomized to Angiotensin-Converting Enzyme Inhibitor or Calcium Channel Blocker vs Diuretic. JAMA. 2002; 288: 2981-2997. ( Link )