The design of ALLHAT may have biased the study's outcome in favor of the diuretic cohort
Lee A Hebert*, Brad H Rovin and Christopher J Hebert
Correspondence *Ohio State University Medical Center, 1654 Upham Drive, Columbus, OH 43210, USA
Email lee.hebert@osumc.edu
The US National High Blood Pressure Education Program currently advocates diuretics as first-line treatment for all patients with hypertension, based mainly on the findings of ALLHAT. This Viewpoint identifies several flaws in the design of ALLHAT that call into question the validity of its conclusions. The authors argue that by encouraging use of angiotensin-converting-enzyme inhibitors and calcium channel blockers in ways that are not the standard of care, the trial likely exaggerated the benefits of diuretics in this setting.
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