Impact of ALLHAT on the Role of Angiotensin-Converting Enzyme Inhibitors in the Primary Prevention of Heart Failure
Authors: Ali Ahmed
Journal: Annals of Internal Medicine (2004)

Letters6 July 2004Impact of ALLHAT on the Role of Angiotensin-Converting Enzyme Inhibitors in the Primary Prevention of Heart FailureAli Ahmed, MD, MPHAli Ahmed, MD, MPHFrom University of Alabama at Birmingham, Veterans Affairs Medical Center, and Alabama Quality Assurance Foundation, Birmingham, AL 35294-2041.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-141-1-200407060-00037-w1 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We read with interest the article by Dr. Messerli on the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) (1). One of the “soft findings” of ALLHAT was that patients receiving lisinopril (versus chlorthalidone) had a significant 20% increased risk for heart failure (2). The risk for heart failure in patients with hypertension is time-dependent and increases with increasing blood pressure levels, even within normal ranges (3). In ALLHAT, patients receiving chlorthalidone and those receiving lisinopril achieved a mean systolic blood pressure of 135.9 mm Hg in 2 and 5 years, respectively (2). This might ...References1. Messerli FH. ALLHAT, or the soft science of the secondary end point. Ann Intern Med. 2003;139:777-80. [PMID: 14597462] LinkGoogle Scholar2. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA. 2002;288:2981-97. [PMID: 12479763] CrossrefMedlineGoogle Scholar3. Vasan RS, Larson MG, Leip EP, Evans JC, O'Donnell CJ, Kannel WB, et al . Impact of high-normal blood pressure on the risk of cardiovascular disease. N Engl J Med. 2001;345:1291-7. [PMID: 11794147] CrossrefMedlineGoogle Scholar4. Reisin E, Weir MR, Falkner B, Hutchinson HG, Anzalone DA, Tuck ML. Lisinopril versus hydrochlorothiazide in obese hypertensive patients: a multicenter placebo-controlled trial. Treatment in Obese Patients With Hypertension (TROPHY) Study Group. Hypertension. 1997;30:140-5. [PMID: 9231834] CrossrefMedlineGoogle Scholar5. Effect of enalapril on mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fractions. The SOLVD Investigators. N Engl J Med. 1992;327:685-91. [PMID: 1463530] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of Alabama at Birmingham, Veterans Affairs Medical Center, and Alabama Quality Assurance Foundation, Birmingham, AL 35294-2041.Grant Support: Dr. Ahmed is supported by a National Institutes of Health Mentored Patient-Oriented Research Career Development Award (1-K23-AG19211-01). PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoALLHAT, or the Soft Science of the Secondary End Point Franz H. Messerli Impact of ALLHAT on the Role of Angiotensin-Converting Enzyme Inhibitors in the Primary Prevention of Heart Failure Franz H. Messerli Metrics 6 July 2004Volume 141, Issue 1Page: W-9KeywordsACE inhibitorsBlood pressureCareers in researchDrugsHeart failureHypertensionMyocardial infarctionRenal diseasesStable coronary artery diseaseSystolic pressure ePublished: 6 July 2004 Issue Published: 6 July 2004 Copyright & PermissionsCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...