Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial

Clinical trial on hypertension and cholesterol management

The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) was a large-scale clinical trial designed to determine the best treatment strategies for preventing heart attacks and other cardiovascular events in patients with hypertension and dyslipidemia. The study was sponsored by the National Heart, Lung, and Blood Institute (NHLBI) and involved over 42,000 participants.

Background

Hypertension and high cholesterol are major risk factors for cardiovascular disease, which is the leading cause of death worldwide. The ALLHAT trial aimed to compare the effectiveness of different classes of antihypertensive and lipid-lowering medications in reducing the incidence of heart attacks and other cardiovascular events.

Study Design

Hypertension is a major risk factor for cardiovascular disease

The ALLHAT trial was a randomized, double-blind, multicenter study. Participants were randomly assigned to receive one of several antihypertensive medications, including a diuretic, a calcium channel blocker, an angiotensin-converting enzyme inhibitor, or an alpha-blocker. Additionally, a subset of participants with elevated cholesterol levels was assigned to receive either a statin or usual care.

Participants

The trial enrolled men and women aged 55 years and older who had hypertension and at least one additional risk factor for coronary heart disease. The diverse participant pool included a significant number of African American and Hispanic individuals, reflecting the demographics of the general population.

Interventions

Participants were assigned to one of the following antihypertensive treatments:

• Chlorthalidone (a diuretic)
• Amlodipine (a calcium channel blocker)
• Lisinopril (an ACE inhibitor)
• Doxazosin (an alpha-blocker)

For lipid-lowering therapy, participants with elevated cholesterol were assigned to receive either:

• Pravastatin (a statin)
• Usual care (diet and lifestyle modifications)

Results

The ALLHAT trial found that the diuretic chlorthalidone was as effective as, or more effective than, the other antihypertensive agents in preventing major cardiovascular events. The study also demonstrated that statin therapy was beneficial in reducing cholesterol levels and preventing heart attacks in patients with dyslipidemia.

Conclusions

The findings of the ALLHAT trial have had a significant impact on clinical practice guidelines for the management of hypertension and dyslipidemia. The results support the use of diuretics as a first-line treatment for hypertension and highlight the importance of statin therapy in patients with elevated cholesterol levels.

Related pages

• Hypertension
• Cholesterol
• Cardiovascular disease
• Clinical trial