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To settle the debate about first-line drug therapy for hypertension, the NIH sponsored the Antihypertensive and Lipid-Lowering treatment to prevent Heart Attack Trial (ALLHAT). The long-awaited results now have been published.
This double-blind, randomized trial involved 33,357 people (age, 55 or older) with hypertension and at least 1 other coronary risk factor. Participants received the thiazide diuretic chlorthalidone, the calcium-channel blocker amlodipine, the angiotensin-converting-enzyme inhibitor lisinopril, or the α-blocker doxazosin. Patients who needed additional medication were given open-label atenolol, reserpine, or clonidine. The doxazosin arm was terminated in 2000 because of a high incidence of congestive heart failure in th…