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ALLHAT
About the Trial
The Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial randomized over 42,000 hypertensive patients to chlorthalidone, amlodipine, lisinopril, or doxazosin. The doxazosin arm stopped early: 2 fold more heart failure. Final results: none of the newer drugs beat the old diuretic for the primary endpoint, and chlorthalidone prevented more heart failure. ALLHAT showed newer and costlier is not better, influencing guidelines that favored thiazide type diuretics as first line. The companion lipid arm found pravastatin did not beat usual care. Funded mainly by NHLBI, ALLHAT remains a model of publicly funded comparative effectiveness research.
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