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Baseline Characteristics of the Diabetic Participants in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT)

¹ Division of Endocrinology, Kaiser Permanente of Georgia, Tucker, Georgia
² Department of Biometry, University of Texas School of Public Health, Houston, Texas
³ Department of Medicine, Ralph H. Johnson Veterans Administration Medical Center, Charleston, South Carolina
⁴ Public Health Sciences and Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina
⁵ Geriatric Medicine Department, Cleveland Clinic Florida, Fort Lauderdale, Florida
⁶ Department of Hypertension and Lipid Metabolism, Atlanta VA Medical Center, Atlanta, Georgia
⁷ Division of Cardiovascular Diseases, Howard University, Washington, D.C.

OBJECTIVE—Hypertension (HTN) is a major risk factor for cardiovascular disease (CVD) in the setting of diabetes. There is no consensus on how best to treat hypertension among those with diabetes. Here we describe the characteristics of a cohort of hypertensive adults with diabetes who are part of a large prospective blood pressure study. This study will help clarify the treatment of HTN in the setting of diabetes.

RESEARCH DESIGN AND METHODS—The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) is a double-blind randomized trial of 42,448 high-risk hypertensive participants, ages 55 years, designed to determine whether the incidence of fatal and nonfatal coronary heart disease (CHD) and combined cardiovascular events (fatal and nonfatal CHD, revascularization surgery, angina pectoris, congestive heart failure, and stroke) differs between diuretic (chlorthalidone) treatment and three alternative antihypertensive therapies: a calcium channel blocker (amlodipine), an ACE inhibitor (lisinopril), and an alpha-adrenergic blocker (doxazosin). The planned follow-up is an average of 6 years, to be completed March 2002.

RESULTS—There are 15,297 diabetic individuals in the ALLHAT study (36.0% of the entire cohort). Of these individuals, 50.2% are male, 39.4% are African-American, and 17.7% are Hispanic. Demographic and laboratory characteristics of the cohort are similar to those of other studies of the U.S. elderly population with HTN. The sample size has 42 and 93% confidence, respectively, for detecting a 16% difference between the diuretic and each of the nondiuretic treatments for the two study outcomes.

CONCLUSIONS—The diabetic cohort in ALLHAT will be able to provide valuable information about the treatment of hypertension in older diabetic patients at risk for incident CVD.

Abbreviations: ADA, American Diabetes Association • ALLHAT, Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial • BP, blood pressure • CHD, coronary heart disease • CHF, congestive heart failure • CVD, cardiovascular disease • ECG, electrocardiogram • HTN, hypertension • IFG, impaired fasting glucose • LVH, left ventricular hypertrophy • MI, myocardial infarction • NHANES, National Health and Nutrition Examination Survey • PAD, peripheral arterial disease

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