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QUESTION: In older patients with well controlled hypertension and moderately elevated low density lipoprotein cholesterol (LDL-C), is pravastatin better than usual care in reducing all cause mortality and coronary heart disease (CHD) events?
Design
Randomised (allocation concealed*), unblinded,* controlled trial with mean 4.8 years of follow up (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial [ALLHAT-LLT]).
Setting
513 clinical centres in the US, Canada, Puerto Rico, and the US Virgin Islands.
Patients
10 355 patients (mean age 66 y, 51% men) who were enrolled in the ALLHAT (age ≥55 y and stage 1 or 2 hypertension with ≥1 additional risk factor for CHD; fasting LDL-C concentration 3.1–4.9 mmol/l for those with no known CHD, or 2.6–3.3 mmol/l for those with known …
Footnotes
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Sources of funding: National Heart, Lung, and Blood Institute and Pfizer.
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For correspondence: Dr J L Probstfield, University of Washington Medical Center, Seattle, WA, USA. jeffp{at}swog.fhcrc.org. Dr B R Davis, University of Texas-Houston Health Science Center, Houston, TX, USA. bdavis{at}sph.uth.tmc.edu
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Abstract and commentary also appear in ACP Journal Club