If this is not your name, click here.
| | If this is not your name, click here. | | |
| | Contact Us | Order Now | Journals | Bookstore | Register a colleague | | |
| |  Long-Term Data Confirm Findings of Heart Attack Prevention Trial: Presented at AHA By Bruce Sylvester ORLANDO, Fla -- November 20, 2009 -- An analysis of long-term, post-trial data from the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack (ALLHAT) trial confirms the original trial conclusions that amlodipine, lisinopril, or doxazosin-based treatments are not superior to chlorthalidone-based treatment in preventing major cardiovascular disease (CVD) events. “However, since there was no difference in CVD or CVD mortality over the entire follow-up period, this does not suggest that lisinopril should be preferred over chlorthalidone for initial treatment of hypertension,” said William Cushman, MD, University of Tennessee Health Sciences Center, Memphis, Tennessee, on November 18 at the American Heart Association (AHA) Scientific Sessions 2009. The investigators conducted a post-trial, passive follow-up through 2006 in order to compare long-term effects of antihypertensive treatments used in ALLHAT, especially for CHD and total mortality, and whether differences observed in ALLHAT for heart failure and aggregate CVD persisted over time. They tracked deaths and hospitalisations for major outcomes using the National Death Index, Social Security Administration, Centers for Medicare and Medicaid Services, and United States Renal Data System. Mortality data was available on 41,719 patients. Combined morbidity and mortality data was available on 27,246 patients. Mean baseline age was 67 years, 47% were women, 35% black, 19% Hispanic, and 36% diabetic. Dr. Cushman reported that for the primary endpoint of all-cause and CVD mortality, neither amlodipine versus chlorthalidone and for lisinopril versus chlorthalidone achieved statistical significance (P = .43 and P = .19, respectively). Likewise for the endpoint of CHD, neither amlodipine versus chlorthalidone and for lisinopril versus chlorthalidone achieved statistical significance (P = .95 and P = .64, respectively). Cardiovascular outcome differences during the ALLHAT trial did not persist, except an excess of heart failure remained in the amlodipine group versus chlorthalidone (P = .01). No new statistically significant differences in major outcomes developed after subjects were removed from blinded therapies. Funding for this study was provided by the National Heart, Lung and Blood Institute (US). [Presentation title: Long-Term Follow-Up in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). Abstract LB.04]
|
