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Pravastatin was not better than usual care in reducing all cause mortality or CHD events

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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 …

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Footnotes

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

  • 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

  • Abstract and commentary also appear in ACP Journal Club

  • * See glossary.