Volume 178 - Issue 6
The verdict from ALLHAT
Author: Mark R Nelson
Med J Aust 2003; 178 (6): 304.
Published online: 17 March 2003
Published online: 17 March 2003
To the Editor: The publication of the main results of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT), and the accompanying editorial, triumph the role of thiazide diuretics as first-line management for hypertension.1,2 It brought to mind the lines from the nursery rhyme Old Mother Hubbard — "And when she went there, the cupboard was bare."
Simple frequency analysis of diuretic antihypertensive medications listed in the Australian Medicines Handbook (1998 and 2003) revealed that the total number of thiazide diuretics available as monotherapy in 1998 was six (bendrofluazide chlorothiazide, chlorthalidone, hydrochlorothiazide, methyclothiazide and indapamide), and in 2003 three (bendrofluazide, chlorthalidone and indapamide).3,4
References
- Appel L. The verdict from ALLHAT — thiazide diuretics are the preferred initial therapy for hypertension. JAMA 2002; 288: 3039-3042.
- The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. 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: 2981-2997.
- Australian Medicines Handbook, 1st edition. Adelaide: Australian Medicines Handbook Pty Ltd, 1998.
- Australian Medicines Handbook, 4th edition. Adelaide: Australian Medicines Handbook Pty Ltd, 2003. i1082270
Fatty Liver Disease in Australia: A Narrative Review on the Epidemiology, Natural History, Prognostication and Management in People With Metabolic Dysfunction
Karl Vaz, Daniel Clayton-Chubb, William W. Kemp, Stuart K. Roberts, Ammar Majeed
Sex Differences in Management and Outcomes of People With ST-Elevation Myocardial Infarction, New South Wales, 2011–2020: A Retrospective Cohort Study
Adam C. Livori, Jedidiah I. Morton, Dianna J. Magliano, Jonathan E. Shaw
Rethinking Rheumatic Fever Diagnosis: Progress, Pitfalls and the Path Towards a Definitive Test
Anna P. Ralph, Rachel Webb, Tom Parks, Nicole J. Moreland, Asha C. Bowen, Benjamin Jones, Emma Ndagire, Andrea Z. Beaton
Sex Differences in Management and Outcomes of People With ST-Elevation Myocardial Infarction, New South Wales, 2011–2020: A Retrospective Cohort Study
Samia Kazi, Simone Marschner, Clara K. Chow
Distribution of Cardiovascular Disease Risk Based on the Updated 2023 Guideline-Recommended Australian Cardiovascular Disease Risk Algorithm and Comparison With the 2012 Algorithm: An Observational Study
Nina Lazarevic, Meghana Bhat, Grace Joshy, Danielle C. Butler, Mark Woodward, Anushka Patel, Rod T. Jackson, Garry Jennings, Rosemary Wyber, Ellie Paige, Emily Banks
They Brought the Hospital to Me
Hugh N. Burrill