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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ALLHAT – Wiki Journal Club

Estimating equations for glomerular filtration rate in the era of creatinine standardization: Posttrial follow-up was conducted through the end ofusing passive surveillance via national databases. Moreover, during the posttrial period, the choice of blood pressure medication was no longer constrained by the study protocol; therefore, those originally randomized to receive chlorthalidone might have stopped using this medication and nonchlorthalidone users might have begun to take a thiazide diuretic.

The defense of the preeminence of diuretics does not sufficiently emphasize that patients treated with chlorthalidone presented a significantly higher incidence of hypokalemia, hyperglycemia, hypercholesterolemia, increased creatinine or new diagnosis of diabetes.

A total of 33 participants aged 55 years or older with hypertension and at least 1 other CHD risk factor from North American centers. Chlorthalidone use was associated with a significantly lower risk of fracture compared with lisinopril use HR, 0. We hypothesized fewer in-trial fracture hospitalizations in those randomized to chlorthalidone vs comparators and that this benefit would persist into the posttrial surveillance period when participants were no longer randomized to study medications.


Low dose beta-blocker prevents ovariectomy-induced bone loss in rats without affecting heart functions. Sign in to make a comment Sign in to your personal account.

Cardiovascular Medications and Fractures.

Design and Conclusions of the ALLHAT Study

Medications supplied by Pfizer amlodipine, doxazosinAstraZeneca atenolol, lisinopril and Bristol-Myers Squibb pravastatin. Such a finding is at odds with 2 other studies.

The groups were equally balanced in all aspects except that in-trial participants randomized to estueio chlorthalidone had more baseline CHD than the amlodipine and lisinopril groups Fracture rates and graphs used the Kaplan-Meier method. Less is known regarding the effects of angiotensin-converting enzyme inhibitors ACEis and calcium channel blockers CCBs on fracture risk despite their ubiquitous use in older adults with hypertension.

Thiazide diuretics and the risk for hip fracture. No specific funding was allocated for etsudio work presented in this article.

No statistically significant differences were observed. In patients with hypertension, chlorthalidone, amlodipine, and lisinopril performed similarly in regards to fatal CAD and nonfatal MI. Calls from Spain 88 87 40 9 to 18 hours. Risk of falls associated with antihypertensive medication: The claim that diuretics are the initial treatment for hypertension is also incorrect because the number of patients receiving a diuretic as the initial treatment is unknown.

Hypertension and osteoporotic fractures are age-related disorders whose incidences increase rapidly after the age of 65 years.

Atenolol use was not ascertained at baseline. 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 fractures. Because participants who were already taking atenolol at baseline were allowed to continue to take atenolol and atenolol was a step 2 drug, participants taking atenolol at the first follow-up visit 1 month were assumed to be taking atenolol at baseline.


Individuals were censored for outcomes if they died, had no outcome in the database by the end of the study, or were lost to follow-up. Administrative, technical, or material support: They should be preferred for first-step antihypertensive therapy.

The VA data files were not available for the posttrial follow-up ; therefore, the posttrial cohort was limited to US citizens with Medicare Part A insurance at randomization Figure 1. Purchase access Subscribe to the journal.

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Thiazide for the postponement of postmenopausal bone loss. No significant difference was found between those taking or not taking atenolol.

Privacy Policy Terms of Use. Create estuido free personal account to make a comment, download free article PDFs, sign up for alerts and more. Trends in osteoporosis treatment with oral and intravenous bisphosphonates in the United States, Recruitment was from February to January ; in-trial follow-up ended in March During the trial, fractures occurred.