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  • Amlodipine or lisinopril was not better than chlorthalidone for reducing CVD risk in hypertensive black or non-black patients

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Therapeutics
Amlodipine or lisinopril was not better than chlorthalidone for reducing CVD risk in hypertensive black or non-black patients

https://doi.org/10.1136/ebm.10.6.170

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    Wright JT Jr, Dunn JK, Cutler JA, et al. Outcomes in hypertensive black and nonblack patients treated with chlorthalidone, amlodipine, and lisinopril. JAMA 2005;293:1595–608.
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 Q In black or non-black patients with hypertension, is amlodipine or lisinopril better than chlorthalidone for reducing cardiovascular disease (CVD)?

    Clinical impact ratings GP/FP/Primary care ★★★★★★☆ IM/Ambulatory care ★★★★★☆☆ Cardiology ★★★★★★☆

    METHODS

    Embedded ImageDesign:

    randomised controlled trial (Antihypertensive and Lipid-lowering Treatment to Prevent Heart Attack Trial [ALLHAT]).

    Embedded ImageAllocation:

    concealed.*

    Embedded ImageBlinding:

    blinded {clinicians, patients, data collectors, outcome assessors, and steering committee}†.*

    Embedded ImageFollow up period:

    mean 4.9 years.

    Embedded ImageSetting:

    623 centres in the US, Canada, Puerto Rico, and the US Virgin Islands.

    Embedded ImagePatients:

    33 357 black and non-black patients ⩾55 years of age (mean age 67 y, 35% black, 53% men overall, 54% women among blacks) who had hypertension with ⩾1 additional risk factor for coronary heart disease (CHD), including left ventricular [LV] hypertrophy, type 2 diabetes, current smoker, high density lipoprotein cholesterol concentration <0.9 mmol/l (35 mg/dl), and myocardial infarction (MI) …

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    Footnotes

    • ↵* See glossary.

    • ↵† The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT).

    • For correspondence: Dr J T Wright Jr, Case Western Reserve University, Cleveland, OH, USA. jackson.wright{at}case.edu

    • Source of funding: National Heart, Lung, and Blood Institute.