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Macaulay A. C. Onuigbo, MD, MSc, FWACP, FASN

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

I read with interest and curiosity the recent revisitation of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) trial by Wright et al.¹ They concluded that current evidence confirmed that neither -blockers, angiotensin-converting enzyme inhibitors (ACEIs), nor calcium channel blockers (CCBs), surpass thiazide-type diuretics (at an appropriate dosage) as initial therapy for reduction of cardiovascular or renal risk.¹ We cannot agree more, especially in light of recent trials including the ONTARGET trial² and new insights into plausible benefits of cardioprotection and renoprotection using different antihypertensive classes.^3-4

We were surprised that the ALLHAT revisitation did not go further than just this statement^1(p834):

Thus, compared with diuretic-based treatment, CCB- and ACE-inhibitor based therapies failed to demonstrate superiority in the prevention of CVD [cardiovascular disease] or ESRD [end-stage renal disease] in participants with DM [diabetes mellitus].

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RELATED ARTICLE

ALLHAT Findings Revisited in the Context of Subsequent Analyses, Other Trials, and Meta-analyses
Jackson T. Wright, Jr, Jeffrey L. Probstfield, William C. Cushman, Sara L. Pressel, Jeffrey A. Cutler, Barry R. Davis, Paula T. Einhorn, Mahboob Rahman, Paul K. Whelton, Charles E. Ford, L. Julian Haywood, Karen L. Margolis, Suzanne Oparil, Henry R. Black, Michael H. Alderman, and for the ALLHAT Collaborative Research Group
Arch Intern Med. 2009;169(9):832-842.
ABSTRACT | FULL TEXT  

RELATED LETTER

ALLHAT Findings Revisited in the Context of Subsequent Analyses, Other Trials, and Meta-analyses—Reply
Jackson T. Wright, Jr, Jeffrey L. Probstfield, William C. Cushman, Sara Pressel, Jeffrey A. Cutler, Barry R. Davis, Paula T. Einhorn, Mahboob Rahman, Paul K. Whelton, Charles E. Ford, L. Julian Haywood, Karen L. Margolis, Suzanne Oparil, Henry R. Black, Michael H. Alderman, and for the ALLHAT Collaborative Research Group
Arch Intern Med. 2009;169(19):1810-1811.
EXTRACT | FULL TEXT