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The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT): ALL predictable, and no big surprise out of a HAT?

Journal of Human Hypertension volume 17, pages 367–372 (2003)Cite this article

In May 2001, the following paragraph appeared in the Journal of Human Hypertension:1 ‘All too few clinicians are aware that possibly the most successful antihypertensive drugs are the thiazide diuretics. They have been shown in many studies, particularly in older patients, to be the best option for lowering blood pressure (BP) as well as preventing heart attacks and strokes. They are also much more cost effective than other first-line agents’.

One could now argue that cynical clinical pharmacologists and die-hard diuretic enthusiasts have (probably) been vindicated with the publication of the results of the largest hypertension clinical trial ever conducted—the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT).2 This study reported that the incidence of the primary end points of fatal coronary heart disease (CHD) and nonfatal myocardial infarction (MI) was identical with a thiazide diuretic, an angiotensin-converting enzyme (ACE) inhibitor, and a dihydropyridine calcium-channel blocker (CCB).

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  1. University Department of Medicine, City Hospital, Birmingham, UK

    D G Beevers, K W Lee & G Y H Lip

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  1. D G Beevers
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Correspondence to G Y H Lip.

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Beevers, D., Lee, K. & Lip, G. The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT): ALL predictable, and no big surprise out of a HAT?. J Hum Hypertens 17, 367–372 (2003). https://doi.org/10.1038/sj.jhh.1001556

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