Diuretic versus alpha-blocker as first-step antihypertensive therapy: final results from the Antihypertensive and Lipid-Lowering Treatment to Prevent XXXX Trial (ALLHAT).

@entity1 @entity4736 @entity64 @entity712 @entity101 @entity583 @entity301 @entity3657 @entity16427 @entity299 @entity9804 @entity65
The Antihypertensive and Lipid-Lowering Treatment to Prevent @entity299 Trial (ALLHAT) was a randomized, double-blind, active, controlled clinical trial conducted to determine whether newer antihypertensive agents, including @entity16427 , an alpha-blocker, differ from @entity9804 , a diuretic, with respect to @entity301 ( @entity301 ) and other @entity65 ( @entity65 ) events in @entity101 @entity1 at high risk of @entity301 . In February 2000, the @entity16427 treatment arm was discontinued, and findings through December 1999 were reported. This report includes an additional 9232 @entity1 -years and 939 @entity65 events. At 623 clinical centers, @entity1 (aged >or=55 years) with @entity101 and at least 1 other @entity301 risk factor were randomly assigned to either @entity9804 or @entity16427 . The primary outcome measure was the combined occurrence of fatal @entity301 or nonfatal @entity583 ( @entity583 ), analyzed by intent to treat; prespecified secondary outcome measures included all-cause mortality, @entity64 , combined @entity301 (fatal @entity301 , nonfatal @entity583 , hospitalized angina, and coronary revascularization), and combined @entity65 (combined @entity301 , @entity64 , angina treated outside the hospital, @entity712 , and @entity3657 ). Mean follow-up was 3.2 years. There was no difference in primary outcome between the arms (relative risk [RR], 1.02; 95% confidence interval [CI], 0.92 to 1.15). All-cause mortality also did not differ (RR, 1.03; 95% CI, 0.94 to 1.13). However, the @entity16427 arm compared with the @entity9804 arm had a higher risk of @entity64 (RR, 1.26; 95% CI, 1.10 to 1.46) and combined @entity65 ( @entity4736 .20; 95% CI, 1.13 to 1.27). These findings confirm the superiority of diuretic-based over alpha-blocker-based antihypertensive treatment for the prevention of @entity65 .
