ALLHAT
Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial
Patient / Population Intervention / Exposure Comparison Outcome
In 33,357 hypertensive patients ≥ 55 with ≥ 1 CV risk factor, chlorthalidone was at least as effective as amlodipine or lisinopril for preventing fatal CHD or non-fatal MI.
N
33,357
Design
Double-blind RCT, mean 4.9 yr
Endpoint
Fatal CHD or non-fatal MI
Relevance
2
ResultPrimary endpoint similar across arms. Chlorthalidone better than lisinopril for stroke; better than amlodipine for HF.
ALLHAT Officers. JAMA. 2002;288(23):2981-2997. 10.1001/jama.288.23.2981
Discussion & critique
Doxazosin arm stopped early for HF excess. Cemented thiazide-type diuretic as a reasonable first-line. Subgroup interpretations (black/non-black) shaped JNC/AHA guidance.