Major Cardiovascular Events in Hypertensive Patients Randomized to Doxazosin vs Chlorthalidone: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT)

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Abstract
The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) is a randomized, double-blind, active-controlled trial sponsored by the National Heart, Lung, and Blood Institute (NHLBI). ALLHAT is designed to determine whether the incidence of the primary outcome—a composite of fatal coronary heart disease (CHD) and nonfatal myocardial infarction (MI)—differs between treatment with a diuretic (chlorthalidone) and treatment with each of 3 other types of antihypertensive drugs—a calcium antagonist (amlodipine), an angiotensin-converting enzyme inhibitor (lisinopril), and an α-adrenergic blocker (doxazosin)—in high-risk hypertensive persons aged 55 years or older. Secondary outcomes include all-cause mortality, stroke, and all major cardiovascular disease (CVD) events. In addition, many ALLHAT participants with mild-to-moderate hypercholesterolemia (n=10,337) are also participating in a randomized, open-label trial designed to determine whether in this population, lowering serum low-density lipoprotein cholesterol levels with a 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase inhibitor (pravastatin) reduces all-cause mortality compared with a control group receiving usual care. Patient enrollment began in February 1994 and active follow-up is scheduled to end in March 2002.1