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Published in , the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) sought to determine which of. Request PDF on ResearchGate | On Jul 1, , José Ramón González- Juanatey and others published Después del estudio ALLHAT, ¿qué sabemos de lo que. Después del estudio ALLHAT, ¿qué sabemos de lo que desconocíamos sobre el and Lipid Lowering Treatment to Prevent Heart Attack Trial (ALLHAT).

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A logical interpretation of this finding is to accept the null hypothesis and claim that the new drugs are not superior to diuretics, and indeed this is stated in the commentary section of the ALLHAT study.

Design and Conclusions of the ALLHAT Study

Such ascertainment results in less underestimation of hip fracture incidence than methods based on self-report. JAMA Esudio 8; 2: To determine whether treatment with a calcium channel blocker or an angiotensin-converting enzyme inhibitor lowers the incidence of coronary heart disease CHD or other cardiovascular disease CVD events vs treatment with a diuretic.

Outcomes analysis used an intention-to-treat approach. The Rotterdam study 18 reported that the presumed hip fracture protective effect of thiazides disappeared 4 months after discontinuation of diuretic therapy.

Copyright American Medical Association. Data are summarized as means SDs for continuous variables and numbers percentages of study participants for categorical variables. They should be preferred for first-step antihypertensive therapy. Recruitment was from February 1,through January 31, ; in-trial follow-up ended March 31, To answer these questions, we used 2 estufio. Acquisition, analysis, or interpretation of data: Hypertension is a major risk factor for numerous conditions including CAD.


During the entire trial and posttrial period of zllhat, the cumulative incidence of fractures was nonsignificantly lower in participants randomized to receive chlorthalidone vs lisinopril or amlodipine HR, 0.

Participants were randomly assigned to receive chlorthalidone, During the in-trial period mean [SD] follow-up, 3. Study concept and design: No significant difference was found between those taking or not taking atenolol.

Drs Davis and Barzilay had full access to qllhat of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

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The unadjusted HR for atenolol users was 1. Usable articles Nephrology Cardiology. For lisinopril vs chlorthalidone, lisinopril had higher 6-year rates of combined CVD These fracture types are well captured in administrative data sets and are serious fracture types that can be associated with mortality.

No other disclosures were reported. This study has important strengths. Recruitment was from February to January ; in-trial follow-up ended in March The defense of the preeminence of diuretics does not sufficiently emphasize that patients treated with chlorthalidone presented a significantly higher incidence of hypokalemia, hyperglycemia, hypercholesterolemia, increased creatinine or new diagnosis of diabetes. The authors outside the Coordinating Center did not have access to participant-level identifying data.


For amlodipine vs chlorthalidone, secondary outcomes were similar except for a higher 6-year rate of HF with amlodipine Create a free personal account to download free article PDFs, sign up for alerts, customize your interests, and more.

Hip fracture in patients with non-dialysis-requiring chronic kidney disease [published online May 4, ].

Design and Conclusions of the ALLHAT Study | Revista Española de Cardiología (English Edition)

When we examined the in-trial fracture risk in users of lisinopril and amlodipine separately, we found a significantly higher risk in those randomized to receive lisinopril but not amlodipine compared with chlorthalidone.

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Our cohort was large and well characterized, allowing adjustment for variables that affect bone health. Antihypertensive medications, bone mineral density, and fractures: J Bone Miner Metab.

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Thiazide diuretics and the risk of hip fracture. In all instances, use of chlorthalidone was associated with a lower risk of fracture than amlodipine or lisinopril.