In December 2002, the long-anticipated results of the Antihypertensive
and Lipid Lowering to protect against Heart Attacks Trial (ALLHAT),
the largest hypertension clinical trial ever conducted, were presented
at a press conference organized by the National Heart, Lung, and Blood
Institute (NHLBI), which supported the study, and the formal presentation
of the trial results was simultaneously published in the December
18, 2002, issue of JAMA.[1]
Conducted in 42,418 patients, the 2 most important results of ALLHAT
that have had the largest impact
1. The results with the newer classes of antihypertensive agents were
"as good as" diuretic therapy for protection against the
primary endpoint of the study, prevention of ischemic coronary events.
2. What was the second important result that came out of the
ALLHAT Trial?
1. Hypertension is almost impossible
to control in a geographically disparate and ethnically diverse population
2. We now must treat Pre-Hypertension <120 SP or <80 DP and
<130/80 for those with diabetes
3. The current poor global blood pressure control
rates could be brought into compliance with as few as 2 of the current
classes of antihypertensive drugs in at least two thirds of a geographically
disparate and ethnically diverse population
4. Systolic blood pressure can be brought into compliance
with guideline-mandated target blood pressure levels with 1 or 2 drugs,
but diastolic blood pressure requires the addition of at least 2 further
classes of antihypertensive drugs
5. Blood pressure varies with age and geographic location, but not
with gender, socioeconomic status, or religion
ANSWER: #3 The current poor global blood pressure
control rates could be brought into compliance with as few as 2 of
the current classes of antihypertensive drugs in at least two thirds
of a geographically disparate and ethnically diverse population
December 2002, the long-anticipated results of the Antihypertensive
and Lipid Lowering to protect against Heart Attacks Trial (ALLHAT),
the largest hypertension clinical trial ever conducted, were presented
at a press conference organized by the National Heart, Lung, and Blood
Institute (NHLBI), which supported the study, and the formal presentation
of the trial results was simultaneously published in the December
18, 2002, issue of JAMA.[1]
Conducted in 42,418 patients, the 2 most important results of ALLHAT
that have had the largest impact appear to be the demonstration that:
1. The results with the newer classes of antihypertensive agents were
"as good as" diuretic therapy for protection against the
primary endpoint of the study, prevention of ischemic coronary events.
2. More than 60% of all patients of diverse
ethnic and socioeconomic backgrounds had their blood pressure levels
brought into the range recommended for their health status, but more
than 2/3 of these patients required 2 or more agents to achieve these
target blood pressure goals.
Reference:
Major Outcomes in High-Risk Hypertensive Patients Randomized to Angiotensin-Converting
Enzyme Inhibitor or Calcium Channel Blocker vs Diuretic: The Antihypertensive
and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT).
The ALLHAT Officers and Coordinators for the ALLHAT Collaborative
Research Group. JAMA. 2002;288:2981-3007.
