Abstract | BACKGROUND: The Antihypertensive and Lipid-Lowering treatment to prevent Heart Attack Trial reported that treatment initiated with doxazosin compared with chlorthalidone doubled the risk for heart failure in high-risk hypertensive patients (relative risk, 2.04 [95% CI, 1.79 to 2.32]). Patients assigned to doxazosin therapy had a mean in-trial systolic/diastolic blood pressure 3/0 mm Hg higher than that in patients assigned to chlorthalidone. Sixty-eight percent (6167 of 9061) of the former patients and 59% (9081 of 15 256) of the latter patients were given additional medications to achieve a target blood pressure of less than 140/90 mm Hg. OBJECTIVE: DESIGN: Randomized, double-blind, active-controlled clinical trial. SETTING: 623 sites in the United States and Canada. PATIENTS: Hypertensive patients 55 years of age or older with at least one additional risk factor for cardiovascular disease. INTERVENTION: MEASUREMENTS: Data on blood pressure, medication, and incident heart failure (treated outside hospital, hospitalized, or fatal) from February 1994 through December 1999. RESULTS: After the treatment groups were categorized as having no exposure to open-label medications (monotherapy) or exposure to open-label therapy, the relative risk for heart failure with doxazosin versus chlorthalidone was 3.10 (CI, 2.51 to 3.82) and 1.42 (CI, 1.20 to 1.69), respectively. After adjustment for follow-up systolic/diastolic blood pressure, the overall relative risk was 2.00 (CI, 1.72 to 2.32). CONCLUSION:
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Authors | Barry R Davis, Jeffrey A Cutler, Curt D Furberg, Jackson T Wright, Michael A Farber, James V Felicetta, John D Stokes, ALLHAT Collaborative Research Group |
Journal | Annals of internal medicine
(Ann Intern Med)
Vol. 137
Issue 5 Part 1
Pg. 313-20
(Sep 03 2002)
ISSN: 1539-3704 [Electronic] United States |
PMID | 12204014
(Publication Type: Clinical Trial, Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)
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Chemical References |
- Antihypertensive Agents
- Doxazosin
- Chlorthalidone
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Topics |
- Antihypertensive Agents
(administration & dosage, therapeutic use)
- Blood Pressure
(drug effects)
- Cardiac Output, Low
(etiology, prevention & control)
- Chlorthalidone
(administration & dosage, therapeutic use)
- Double-Blind Method
- Doxazosin
(administration & dosage, therapeutic use)
- Drug Administration Schedule
- Drug Therapy, Combination
- Female
- Humans
- Hypertension
(complications, drug therapy, physiopathology)
- Male
- Middle Aged
- Proportional Hazards Models
- Risk Factors
- Treatment Outcome
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