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Clinical outcomes in antihypertensive treatment of type 2 diabetes, impaired fasting glucose concentration, and normoglycemia: Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT).
| Content Provider | Semantic Scholar |
|---|---|
| Author | Whelton, Paul Kieran Barzilay, J. I. Iiamathi, Ekambaram Leenen, Frans H. H. Mathis, David E. Moloo, Jamal Nwachuku, Chuke E. Panebianco, Deborah Thadani, Udho |
| Copyright Year | 2005 |
| Abstract | BACKGROUND Optimal first-step antihypertensive drug therapy in type 2 diabetes mellitus (DM) or impaired fasting glucose levels (IFG) is uncertain. We wished to determine whether treatment with a calcium channel blocker or an angiotensin-converting enzyme inhibitor decreases clinical complications compared with treatment with a thiazide-type diuretic in DM, IFG, and normoglycemia (NG). METHODS Active-controlled trial in 31 512 adults, 55 years or older, with hypertension and at least 1 other risk factor for coronary heart disease, stratified into DM (n = 13 101), IFG (n = 1399), and NG (n = 17 012) groups on the basis of national guidelines. Participants were randomly assigned to double-blind first-step treatment with chlorthalidone, 12.5 to 25 mg/d, amlodipine besylate, 2.5 to 10 mg/d, or lisinopril, 10 to 40 mg/d. We conducted an intention-to-treat analysis of fatal coronary heart disease or nonfatal myocardial infarction (primary outcome), total mortality, and other clinical complications. RESULTS There was no significant difference in relative risk (RR) for the primary outcome in DM or NG participants assigned to amlodipine or lisinopril vs chlorthalidone or in IFG participants assigned to lisinopril vs chlorthalidone. A significantly higher RR (95% confidence interval) was noted for the primary outcome in IFG participants assigned to amlodipine vs chlorthalidone (1.73 [1.10-2.72]). Stroke was more common in NG participants assigned to lisinopril vs chlorthalidone (1.31 [1.10-1.57]). Heart failure was more common in DM and NG participants assigned to amlodipine (1.39 [1.22-1.59] and 1.30 [1.12-1.51], respectively) or lisinopril (1.15 [1.00-1.32] and 1.19 [1.02-1.39], respectively) vs chlorthalidone. CONCLUSION Our results provide no evidence of superiority for treatment with calcium channel blockers or angiotensin-converting enzyme inhibitors compared with a thiazide-type diuretic during first-step antihypertensive therapy in DM, IFG, or NG. |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | https://ccct.sph.uth.tmc.edu/allhatoutreach/publications/aim2005.pdf |
| Alternate Webpage(s) | https://archinte.jamanetwork.com/journals/INTEMED/articlepdf/486620/ioi50016.pdf |
| Alternate Webpage(s) | http://archinte.jamanetwork.com/pdfaccess.ashx?url=/data/journals/intemed/12032/ioi50016.pdf |
| PubMed reference number | 15983290v1 |
| Volume Number | 165 |
| Issue Number | 12 |
| Journal | Archives of internal medicine |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | 101 Mouse Amlodipine Besylate Angiotensin-Converting Enzyme Inhibitors Angiotensins Antihypertensive Agents Calcium Channel Blockers Cerebrovascular accident Chlorthalidone Confidence Intervals Coronary heart disease Diabetes Mellitus Diabetes Mellitus, Non-Insulin-Dependent Diuretics Glucose Metabolism Disorders Heart Diseases Heart failure Hypertensive disease IFNG gene IFNG wt Allele Lisinopril Myocardial Infarction PersonNameUse - assigned Relative Risk Thiazides milligram/day |
| Content Type | Text |
| Resource Type | Article |
