Barry R. Davis, MD, PhD; Curt D. Furberg, MD, PhD; Jackson T. Wright Jr., MD, PhD; Jeffrey A. Cutler, MD, MPH; Paul Whelton, MD, MSc; and the ALLHAT Collaborative Research Group
Grant Support: By the National Heart, Lung, and Blood Institute (contract N01-HC-35130). The ALLHAT investigators received study medications from Pfizer (amlodipine and doxazosin), AstraZeneca (atenolol and lisinopril), and Bristol-Myers Squibb (pravastatin) and financial support from Pfizer.
Potential Financial Conflicts of Interest:Consultancies: J.T. Wright Jr. (Astra, Aventis, Bayer, Bristol-Myers Squibb, Merck & Co., Novartis Pharma AG, Pfizer, Phoenix Pharmaceuticals, Searle & Co., SmithKline Beecham, Solvay/Unimed); Honoraria: B.R. Davis (Pfizer), J.T. Wright Jr. (Astra, Aventis, Bayer, Bristol-Myers Squibb, Merck & Co., Novartis Pharma AG, Pfizer, Phoenix Pharmaceuticals, Searle & Co., SmithKline Beecham, Solvay/Unimed), P. Whelton (Pfizer); Grants received: J.T. Wright Jr. (Astra, Aventis, Bayer, Bristol-Myers Squibb, Eli Lilly & Co., Merck & Co., Novartis Pharma AG, Pfizer, Searle & Co., SmithKline Beecham, Solvay/Unimed); J.A. Cutler (Pfizer, AstraZeneca, Bristol-Myers Squibb).
Requests for Single Reprints: Barry R. Davis, MD, PhD, The University of Texas Health Science Center at Houston School of Public Health, 1200 Herman Pressler Street, Suite E801, Houston, TX 77030; e-mail, firstname.lastname@example.org.
Current Author Addresses: Dr. Davis: The University of Texas Health Science Center at Houston School of Public Health, 1200 Herman Pressler Street, Suite E801, Houston, TX 77030.
Dr. Furberg: Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 57157-1063.
Dr. Wright: Case Western Reserve University, General Clinical Research Center, Horvitz Tower, Suite 7311, 11100 Euclid Avenue, Cleveland, OH 44106-5041.
Dr. Cutler: National Heart, Lung, and Blood Institute, Division of Epidemiology and Clinical Applications, 6701 Rockledge Drive, Room 8130, Bethesda, MD 20892-7936.
Dr. Whelton: Tulane University Health Sciences Center, 1440 Canal Street TW-5, Suite 2400, New Orleans, LA 70112.
The findings of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) have generated worldwide reaction from clinicians and researchers, including a recent commentary in this journal. Such response was expected for a trial of ALLHAT's size and scope, especially since its results challenged some widely held beliefs. This paper reviews key aspects of the ALLHAT design, analyses, findings, and conclusions to provide a perspective on the commentary about the trial's results and implications for clinical practice. Several of the most frequent comments regarding the study's results are addressed, particularly with respect to heart failure and diabetes outcomes. Responses to these comments reinforce the investigators' original conclusion that thiazide-type diuretics should remain the preferred first-step drug class for treating hypertension and should generally be a part of any multidrug regimen.
Barry R. Davis, Curt D. Furberg, Jackson T. Wright, Jeffrey A. Cutler, Paul Whelton, . ALLHAT: Setting the Record Straight. Ann Intern Med. 2004;141:39–46. doi: 10.7326/0003-4819-141-1-200407060-00013
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Published: Ann Intern Med. 2004;141(1):39-46.
Cardiology, Coronary Risk Factors, Heart Failure, Hypertension, Nephrology.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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