Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT)

Project Background and Goals:

The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) is a practice-based, randomized, clinical trial of antihypertensive drug treatment, and in a subset, cholesterol lowering drug therapy.  The goal is to evaluate 40,000 high-risk hypertensive patients, including a minimum of 55% African-Americans.  The hypertensive part of the trial seeks to determine whether the combined incidence of fatal coronary heart disease (CHD) and non-fatal heart attack differs between diuretics and three other antihypertensive drug treatments: amlodipine, a calcium antagonist; lisinopril, an ACE inhibitor; and doxazesin, an alpha adrenergic blocker.  Because of the known benefit of antihypertensive treatment in the reduction of strokes, total morbidity and mortality from cardiovascular diseases, and all-cause mortality, the antihypertensive trial component is to determine whether lowering serum cholesterol in moderately hypercolesterolemic men and women aged 55 or older with a reductase inhibitor (pravastastin) will reduce all-cause mortality as compared to a control group receiving  "usual care".