Trial reportClinical journal of the American Society of Nephrology : CJASN2012
Long-term renal and cardiovascular outcomes in Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) participants by baseline estimated GFR.
Trial report in Clinical journal of the American Society of Nephrology : CJASN, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 4 syntheses or guidelines pooled it, 94 citations in OpenAlex.
- Pharmacological interventions for heart failure in people with chronic kidney disease.The Cochrane database of systematic reviews · 2020Pooled it
- The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2019).Hypertension research : official journal of the Japanese Society of Hypertension · 2019Guideline
- Pooled it
- 7th Brazilian Guideline of Arterial Hypertension: Chapter 8 - Hypertension and Associated Clinical ConditionsArquivos brasileiros de cardiologia · 2016Guideline
- Chlorthalidone vs Hydrochlorothiazide and Kidney Outcomes in Patients With Hypertension: A Secondary Analysis of a Randomized Clinical Trial.JAMA network open · 2024Trial
- Mortality and morbidity during and after Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial: results by sex.Hypertension (Dallas, Tex. : 1979) · 2013Trial
- Retrospective analysis of influences of sacubitril/valsartan in patients with diabetes with poorly controlled blood pressure in Japan.Journal of diabetes investigation · 2025Article
- Comparison between sacubitril/valsartan and thiazide diuretics among patients with uncontrolled hypertension in Japan.Hypertension research : official journal of the Japanese Society of Hypertension · 2025Article
- Cardiac Effects of Renin-Angiotensin System Inhibitors in Nonproteinuric CKD.Hypertension (Dallas, Tex. : 1979) · 2024Article
- Dihydropyridine Calcium Channel Blockers and Kidney Outcomes.Journal of general internal medicine · 2024Article
- Amlodipine in the current management of hypertension.Journal of clinical hypertension (Greenwich, Conn.) · 2023Review
- Tight Blood Pressure Control in Chronic Kidney Disease.Journal of cardiovascular development and disease · 2022Review
- Chronic Kidney Disease Progression Risk in Patients With Diabetes Mellitus Using Dihydropyridine Calcium Channel Blockers: A Nationwide, Population-Based, Propensity Score Matching Cohort Study.Frontiers in pharmacology · 2022Article
- Association between atherosclerotic cardiovascular diseases risk and renal outcome in patients with type 2 diabetes mellitus.Renal failure · 2021Article
- Renin Angiotensin Aldosterone System Inhibitors in Chronic Kidney Disease: A Difficult Equation.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2021Review
- Questioning the renoprotective role of L-type calcium channel blockers in chronic kidney disease using physiological modeling.American journal of physiology. Renal physiology · 2021Article
- Therapeutic Insights in Chronic Kidney Disease Progression.Frontiers in medicine · 2021Review
- Effects of Posttrial Antihypertensive Drugs on Morbidity and Mortality: Findings from 15-Year Passive Follow-Up after ALLHAT Ended.International journal of hypertension · 2021Article
- Glucose and Blood Pressure-Dependent Pathways-The Progression of Diabetic Kidney Disease.International journal of molecular sciences · 2020Review
- Low statin use in nondialysis-dependent chronic kidney disease in the absence of clinical atherosclerotic cardiovascular disease or diabetes.Clinical kidney journal · 2019Article
Corrections and comments
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Authors and funding
20 authors at 1 institution in 1 country.
Funding
Abstract
BACKGROUND AND
objectivesCKD is common among older patients. This article assesses long-term renal and cardiovascular outcomes in older high-risk hypertensive patients, stratified by baseline estimated GFR (eGFR), and long-term outcome efficacy of 5-year first-step treatment with amlodipine or lisinopril, each compared with chlorthalidone. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This was a long-term post-trial follow-up of hypertensive participants (n=31,350), aged ≥55 years, randomized to receive chlorthalidone, amlodipine, or lisinopril for 4-8 years at 593 centers. Participants were stratified by baseline eGFR (ml/min per 1.73 m(2)) as follows: normal/increased (≥90; n=8027), mild reduction (60-89; n=17,778), and moderate/severe reduction (<60; n=5545). Outcomes were cardiovascular mortality (primary outcome), total mortality, coronary heart disease, cardiovascular disease, stroke, heart failure, and ESRD.
resultsAfter an average 8.8-year follow-up, total mortality was significantly higher in participants with moderate/severe eGFR reduction compared with those with normal and mildly reduced eGFR (P<0.001). In participants with an eGFR <60, there was no significant difference in cardiovascular mortality between chlorthalidone and amlodipine (P=0.64), or chlorthalidone and lisinopril (P=0.56). Likewise, no significant differences were observed for total mortality, coronary heart disease, cardiovascular disease, stroke, or ESRD.
conclusionsCKD is associated with significantly higher long-term risk of cardiovascular events and mortality in older hypertensive patients. By eGFR stratum, 5-year treatment with amlodipine or lisinopril was not superior to chlorthalidone in preventing cardiovascular events, mortality, or ESRD during 9-year follow-up. Because data on proteinuria were not available, these findings may not be extrapolated to proteinuric CKD.
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Registered trials
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