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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For this secondary analysis, which used an intention-to-treat approach, data were analyzed from February 1,through December 31, Hypertension is a major risk factor for numerous conditions including CAD. No statistically significant differences were observed. But such a reduction is to be expected because we can assume that the incidence of such events would allhta greater in a group receiving no treatment than in one receiving treatment.
Allht effect of angiotensin II receptor blockade in adipose tissue and bone.
esyudio A logical interpretation of this finding is to accept the null hypothesis and claim that the new drugs estydio not superior to diuretics, and indeed this is stated in the commentary section of the ALLHAT study.
These fracture types are well captured in administrative data sets estjdio are serious fracture types that can be associated with mortality. Atenolol status at 1 month for the in-trial A and in-trial plus posttrial B cohorts. Drs Davis and Barzilay had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
This page was last modified on 14 Septemberat Journal of the American Medical Association.
Design and Conclusions of the ALLHAT Study
Comparisons are chlorthalidone vs. Assuming a beneficial effect in the chlorthalidone group during the trial, would this pattern continue during the posttrial period ie, is there a legacy effect? No significant difference was found between those taking or not taking atenolol. Analyses were repeated alohat 1 year after randomization to gauge the effects of the medications on fracture risk after trial participants had been estydio to the bone effects of the medications for 1 year.
Participants were randomly assigned to receive chlorthalidone, Fourth, although randomization was generally well allnat during the trial period, there was crossover of medication use.
Acquisition, analysis, or interpretation of data: Medications supplied by Pfizer amlodipine, doxazosinAstraZeneca atenolol, lisinopril and Bristol-Myers Squibb pravastatin. Similar results were noted after adjustment for demographic and clinical variables HR, 0. Similar results were obtained in sensitivity analyses, where the first year of follow-up after randomization was excluded.
The Rotterdam study 18 reported that the presumed hip fracture protective effect of thiazides disappeared 4 months after discontinuation of diuretic therapy. Views Read View source View history.
Adjustment for demographic and clinical variables marginally changed this estimate HR, 1. Study weaknesses should also be acknowledged. In all instances, use of chlorthalidone was associated with a lower risk of fracture than amlodipine or lisinopril. The groups were equally balanced in all aspects except that in-trial participants randomized to receive chlorthalidone had more baseline CHD than the amlodipine and lisinopril groups In addition, it is unlikely that bisphosphonate use would differ by randomized treatment arm.
The risk of hip fracture after initiating antihypertensive drugs in the elderly. Does the use of ACE inhibitors or angiotensin receptor blockers affect bone loss in older men? The in-trial cohort consisted of participants randomized to chlorthalidone, amlodipine, or lisinopril, with or without atenolol at month 1 of follow-up from baseline Figure 1 A.
The doxazosin arm was terminated prematurely because of a significantly increased risk of HF compared to chlorthalidone noted during an interim analysis.
Design and Conclusions of the ALLHAT Study | Revista Española de Cardiología (English Edition)
Zyniecki; Investigators and Coordinators Canada: Zuliani; Prince Edwards Island: Likewise, all-cause mortality did not differ between groups. Outcomes analysis used an intention-to-treat approach. Hypertension and osteoporotic fractures are age-related disorders whose incidences increase rapidly after the age of 65 years. Data are summarized as means SDs for continuous variables and numbers percentages of study participants for categorical variables.
Recruitment was from February 1,through January 31, ; in-trial follow-up ended March 31, During 5 additional years of posttrial follow-up, when medication use was not constrained by study protocol, fracture risk continued to be lower in users of chlorthalidone compared with lisinopril or amlodipine together or alone.
ALLHAT – Wiki Journal Club
Adjusted Cox proportional hazards regression models included age, race, sex, diabetes, eGFR, prevalent CVD, body mass index, and smoking. Register for email alerts with links to free full-text articles Access PDFs of free articles Manage your interests Save searches and receive search alerts. Navigation menu Personal tools Create account Log in. Secondary Analysis of a Randomized Clinical Trial. They should be preferred for first-step antihypertensive therapy.
The authors outside the Coordinating Center did not have access to participant-level identifying data. Surprisingly, the authors then conclude that thiazide diuretics should be the initial treatment in arterial hypertension and should be used, if possible, in association with antihypertensive agents.