文档介绍：Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial
JAMA 2002;288:2981-2997
ALLHAT
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42,418 patients with hypertension
SBP >140mmHg and/or DBP >90 mmHg OR
Took medication for hypertension and had at least one additional risk factor for CHD
Age >55 years
NHLBI funded trial
Diuretic
Chlorthalidone
12-25 mg/day (n=15,255)
Endpoints:
Primary – Fatal coronary heart disease and nonfatal MI
Secondary – All-cause mortality, stroke, and major cardiovascular disease events (CHF, coronary revascularization, angina, and peripheral artery disease)
Mean follow-up years
ALLHAT
JAMA 2002;288:2981-2997
Calcium Channel Blocker
Amlodipine
-10 mg/day
(n=9,048)
ACE Inhibitor Lisinopril
10-40 mg/day
(n=9,054)
Alpha Blocker
Doxazosin*
2-8 mg/day
(n=9,061)
* Discontinued prior to pletion
Chlorthalidone vs Amlodipine
Primary Endpoint
RR =
p =
ALLHAT: Primary Endpoint*
Chlorthalidone
JAMA 2002;288:2981-2997
Amlodipine
* Primary Endpoint = Fatal CHD or nonfatal MI
Chlorthalidone vs Lisinopril
Primary Endpoint
RR =
p =
Chlorthalidone
Lisinopril
All Cause Mortality
RR =
p =
ALLHAT: Secondary Endpoints
Chlorthalidone
JAMA 2002;288:2981-2997
Amlodipine
Heart Failure
RR =
p <
Chlorthalidone
Amlodipine
Chlorthalidone vs Amlodipine
All Cause Mortality