Baseline Characteristics of the Diabetic Participants in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT)
- Joshua I. Barzilay, MD1,
- Cheryl L. Jones, SCD2,
- Barry R. Davis, MD, PHD2,
- Jan N. Basile, MD3,
- David C. Goff, Jr., MD, PHD4,
- Jerry O. Ciocon, MD5,
- Mary Ellen Sweeney, MD6,
- Otelio S. Randall, MD7 and
- for the ALLHAT Collaborative Research Group
- 1Division of Endocrinology, Kaiser Permanente of Georgia, Tucker, Georgia
- 2Department of Biometry, University of Texas School of Public Health, Houston, Texas
- 3Department of Medicine, Ralph H. Johnson Veterans Administration Medical Center, Charleston, South Carolina
- 4Public Health Sciences and Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina
- 5Geriatric Medicine Department, Cleveland Clinic Florida, Fort Lauderdale, Florida
- 6Department of Hypertension and Lipid Metabolism, Atlanta VA Medical Center, Atlanta, Georgia
- 7Division of Cardiovascular Diseases, Howard University, Washington, D.C.
Abstract
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.
- 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
Footnotes
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Address correspondence and reprint requests to Joshua Barzilay, MD, Kaiser Permanente of Georgia, 200 Crescent Ctr., Tucker, GA 30084. E-mail: joshua.barzilay{at}kp.org.
Received for publication 20 July 2000 and accepted in revised form 27 October 2000.
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