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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Although this approach is highly accurate for diagnosing fractures, 23 participants eligible for Medicare who were enrolled in managed care would not have hospitalizations recorded with Medicare, thereby lowering the number of participants with estudo. A positive effect on calcium balance and a direct stimulatory effect on osteoblasts have been proposed as the biological basis for this putative beneficial effect.

Fourth, although randomization was generally well maintained during the trial period, there was crossover of medication use. Posttrial follow-up was conducted estudioo the end ofusing passive surveillance via national databases. Conflict of Interest Disclosures: The primary outcome occurred in participants, with no difference between treatments.

Prescribing patterns for thiazide diuretics in a large health maintenance organization: Analyses were repeated beginning 1 year after randomization to gauge the effects of the medications on fracture risk after trial participants had been exposed to the bone effects of the medications for 1 year.

The mean follow-up was 4. Create a personal account to register for email alerts with links to free full-text articles. In the cohort with in-trial and posttrial follow-up, 69 pelvic and hip fractures occurred during the in-trial and posttrial periods. The funding source had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and the decision to submit the manuscript for publication.


Risk of falls associated with antihypertensive medication: Recent guidelines have been issued jointly by the European societies of hypertension and cardiology. Dr Oparil reports receiving honoraria from Daiichi Sankyo and Novartis. They should be preferred for first-step antihypertensive therapy. 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 JAMA Jan 8; 2: In patients with hypertension, what is the efficacy of a calcium channel blocker, ACE inhibitor, or thiazide diuretic in lowering the incidence of CV events?

Data from randomized clinical trials are lacking. Among all participants, 9.

Participants randomized to receive chlorthalidone vs amlodipine or lisinopril had a lower risk of fracture on adjusted analyses hazards ratio [HR], 0. Adjusted Cox proportional hazards regression models included age, allhxt, sex, diabetes, eGFR, prevalent CVD, body mass index, and smoking.

Get free access to newly published articles. These risk factors included previous myocardial infarction or stroke, left ventricular hypertrophy by electrocardiography or echocardiography, history of type 2 diabetes, current cigarette smoking, and low high-density lipoprotein estuvio level. Our sample was based on participants who had been randomized to their treatment group, minimizing differences between the treatment groups.

Design and Conclusions of the ALLHAT Study

To our knowledge, this analysis provides the first randomized comparison of different antihypertensive medications on risk of hip or pelvic fractures. The doxazosin arm was terminated prematurely because of a significantly increased risk of HF compared to chlorthalidone noted during an interim analysis. Allbat clinical studies suggest lower fracture risk with their use, 1011 although not all studies agree. Cumulative fracture rates are shown in Figure 2 B.

Design and Conclusions of the ALLHAT Study | Revista Española de Cardiología (English Edition)

No statistically significant differences were observed. Davis, Pressel, Louis, Williamson, Barzilay. For the initial curves A and Bin the in-trial cohort, the unadjusted hazard ratio HR was a,lhat. Hazards ratios HRs were adjusted for age, race, sex, diabetes, baseline estimated glomerular filtration rate eGFRprevalent cardiovascular disease CVDbody mass index, and smoking.


Five-year systolic blood pressures were significantly higher in the amlodipine 0. It would have become available in the market 6 months later at the earliest. 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.

Hip fracture in patients with non-dialysis-requiring chronic kidney disease [published online Zllhat 4, ]. Acquisition, analysis, or interpretation of data: This study has important strengths. Moreover, the use of bisphosphonates became common only in the early s, after the release of several large fracture trials. In sensitivity analyses, when 1 year after randomization was used as the baseline to allow for the effects of medications on bone to take effectsimilar results were obtained for in-trial and in-trial plus posttrial follow-up.

Compared with chlorthalidone 6-year rate, The Rotterdam study 18 reported that the presumed hip fracture protective effect of thiazides disappeared 4 months after discontinuation of diuretic therapy. Sign in to customize your interests Sign in to your personal account.

The increased risk appeared by the second year after randomization for those taking amlodipine or lisinopril. Potential effect of angiotensin II receptor blockade in adipose tissue and bone. Hospitalized hip and pelvic fractures International Classification of Diseases, Ninth Revisioncodes Study concept and design: