Mortality and morbidity during and after antihypertensive and lipid-lowering treatment to prevent heart attack trial: Results by sex

Suzanne Oparil, Barry R. Davis, William Cushman, Charles E. Ford, Curt D. Furberg, Gabriel B. Habib, L. Julian Haywood, Karen Margolis, Jeffrey L. Probstfield, Paul K. Whelton, Jackson T. Wright

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

To determine whether an angiotensin-converting enzyme inhibitor (lisinopril) or calcium channel blocker (amlodipine) is superior to a diuretic (chlorthalidone) in reducing cardiovascular disease incidence in sex subgroups, we carried out a prespecified subgroup analysis of 15 638 women and 17 719 men in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). Total follow-up (active treatment + passive surveillance using national administrative databases to ascertain deaths and hospitalizations) was 8 to 13 years. The primary outcome was fatal coronary heart disease or nonfatal myocardial infarction. Secondary outcomes included all-cause mortality, stroke, combined cardiovascular disease (coronary heart disease death, nonfatal myocardial infarction, stroke, angina, coronary revascularization, heart failure [HF], or peripheral vascular disease), and end-stage renal disease. In-trial rates of HF, stroke, and combined cardiovascular disease were significantly higher for lisinopril compared with chlorthalidone, and rates of HF were significantly higher for amlodipine compared with chlorthalidone in both men and women. There were no significant treatment sex interactions. These findings did not persist through the extension period with the exception of the HF result for amlodipine versus chlorthalidone, which did not differ significantly by sex. For both women and men, rates were not lower in the amlodipine or lisinopril groups than in the chlorthalidone group for either the primary coronary heart disease outcome or any other cardiovascular disease outcome, and chlorthalidone-based treatment resulted in the lowest risk of HF. Neither lisinopril nor amlodipine is superior to chlorthalidone for initial treatment of hypertension in either women or men.

Original languageEnglish (US)
Pages (from-to)977-986
Number of pages10
JournalHypertension
Volume61
Issue number5
DOIs
StatePublished - May 1 2013

Fingerprint

Chlorthalidone
Antihypertensive Agents
Amlodipine
Lisinopril
Myocardial Infarction
Morbidity
Lipids
Mortality
Heart Failure
Cardiovascular Diseases
Coronary Disease
Stroke
Therapeutics
Fatal Outcome
Peripheral Vascular Diseases
Calcium Channel Blockers
Angiotensin-Converting Enzyme Inhibitors
Diuretics
Chronic Kidney Failure
Hospitalization

All Science Journal Classification (ASJC) codes

  • Internal Medicine

Cite this

Mortality and morbidity during and after antihypertensive and lipid-lowering treatment to prevent heart attack trial : Results by sex. / Oparil, Suzanne; Davis, Barry R.; Cushman, William; Ford, Charles E.; Furberg, Curt D.; Habib, Gabriel B.; Haywood, L. Julian; Margolis, Karen; Probstfield, Jeffrey L.; Whelton, Paul K.; Wright, Jackson T.

In: Hypertension, Vol. 61, No. 5, 01.05.2013, p. 977-986.

Research output: Contribution to journalArticle

Oparil, S, Davis, BR, Cushman, W, Ford, CE, Furberg, CD, Habib, GB, Haywood, LJ, Margolis, K, Probstfield, JL, Whelton, PK & Wright, JT 2013, 'Mortality and morbidity during and after antihypertensive and lipid-lowering treatment to prevent heart attack trial: Results by sex', Hypertension, vol. 61, no. 5, pp. 977-986. https://doi.org/10.1161/HYPERTENSIONAHA.111.00213
Oparil, Suzanne ; Davis, Barry R. ; Cushman, William ; Ford, Charles E. ; Furberg, Curt D. ; Habib, Gabriel B. ; Haywood, L. Julian ; Margolis, Karen ; Probstfield, Jeffrey L. ; Whelton, Paul K. ; Wright, Jackson T. / Mortality and morbidity during and after antihypertensive and lipid-lowering treatment to prevent heart attack trial : Results by sex. In: Hypertension. 2013 ; Vol. 61, No. 5. pp. 977-986.
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