Standridge John B
Department of Family Medicine, University of Tennessee Health Science Center College of Medicine, Chattanooga Unit, Chattanooga, Tennessee 37403, USA.
Am J Hypertens. 2004 Apr;17(4):361-5. doi: 10.1016/j.amjhyper.2003.11.011.
A key Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) conclusion is that thiazide diuretics should be preferred for first-step antihypertensive therapy. ALLHAT was not a monotherapy trial, and rational drug combinations were discouraged by study design in the lisinopril limb. The ALLHAT conclusion that recommends chlorthalidone for initial hypertension therapy seems unjustified because ALLHAT was not a trial that initiated therapy for hypertension. ALLHAT was not of sufficient length to detect the poorer outcomes that are inevitable with increased rates of diabetes in the chlorthalidone limb. The heart failure subset analysis was not prospectively established. ALLHAT was not designed to make the conclusions claimed by its authors.
抗高血压和降脂治疗预防心脏病发作试验（ALLHAT）的一个关键结论是，噻嗪类利尿剂应作为一线抗高血压治疗的首选。ALLHAT不是一项单一疗法试验，赖诺普利组的研究设计不鼓励使用合理的药物组合。ALLHAT得出的推荐氯噻酮用于初始高血压治疗的结论似乎不合理，因为ALLHAT不是一项启动高血压治疗的试验。ALLHAT的时间长度不足以检测氯噻酮组中糖尿病发病率增加所不可避免的较差结果。心力衰竭亚组分析并非前瞻性设定。ALLHAT并非旨在得出其作者所宣称的结论。
