Trial reportJournal of hypertension2014
Blood pressure control and cardiovascular outcomes in normal-weight, overweight, and obese hypertensive patients treated with three different antihypertensives in ALLHAT.
Trial report in Journal of hypertension, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 51 citations in OpenAlex.
- Pharmacological interventions for heart failure in people with chronic kidney disease.The Cochrane database of systematic reviews · 2020Pooled it
- Anti-hypertensive drug treatment of patients with and the metabolic syndrome and obesity: a review of evidence, meta-analysis, post hoc and guidelines publications.Current hypertension reports · 2015Pooled it
- Effects of Bariatric Surgery in Obese Patients With Hypertension: The GATEWAY Randomized Trial (Gastric Bypass to Treat Obese Patients With Steady Hypertension).Circulation · 2018Trial
- LEADER-4: blood pressure control in patients with type 2 diabetes and high cardiovascular risk: baseline data from the LEADER randomized trial.Journal of hypertension · 2016 · on this mapTrial
- Effect of Antihypertensive Drug Classes on Stroke Prevention: A Systematic Review and Meta-Analysis.Cureus · 2026Review
- Highlights of the 2026 Korean Society of Hypertension guidelines for the management of hypertension: what's new and what has changed.Clinical hypertension · 2026Review
- 2024 Thai guidelines on the treatment of hypertension.Asian biomedicine : research, reviews and news · 2025Article
- Obesity and its management in primary care setting.Journal of diabetes and its complications · 2025Review
- Incidence of new onset arterial hypertension after metabolic bariatric surgery: an 8-year prospective follow-up with matched controls.Journal of hypertension · 2025Article
- First-line diuretics versus other classes of antihypertensive drugs for hypertension.The Cochrane database of systematic reviews · 2023Review
- Antihypertensive medicine use differs between Ghana and Nigeria.BMC cardiovascular disorders · 2022Article
- Is Hypertension Despite Use of Two or More Anti-hypertensive Medications for Patients with a BMI < 40 kg/mObesity surgery · 2022Article
- Evaluation of serum calcium differences in hypertensive crises and control patients: A randomly matched case-control study.Journal of clinical hypertension (Greenwich, Conn.) · 2021Article
- Effect of intensive and standard blood pressure control on cardiovascular outcomes based on body mass index: sub-analysis of the sprint trial.Journal of human hypertension · 2020Article
- Effect of SGLT2 inhibitors on body composition, fluid status and renin-angiotensin-aldosterone system in type 2 diabetes: a prospective study using bioimpedance spectroscopy.Cardiovascular diabetology · 2019 · on this mapObservational
- Hypertension in Obesity and the Impact of Weight Loss.Current cardiology reports · 2017Review
- Opposing tissue-specific roles of angiotensin in the pathogenesis of obesity, and implications for obesity-related hypertension.American journal of physiology. Regulatory, integrative and comparative physiology · 2015Review
- Hydrochlorothiazide is not the most useful nor versatile thiazide diuretic.Current opinion in cardiology · 2015Review
- Health-related quality of life 6 years after bariatric surgery: factors influencing outcome.Porto biomedical journalArticle
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Authors and funding
11 authors at 8 institutions in 1 country.
Funding
Abstract
objectiveEpidemiologically, there is a strong relationship between BMI and blood pressure (BP) levels. We prospectively examined randomization to first-step chlorthalidone, a thiazide-type diuretic; amlodipine, a calcium-channel blocker; and lisinopril, an angiotensin-converting enzyme inhibitor, on BP control and cardiovascular outcomes in a hypertensive cohort stratified by baseline BMI [kg/m(2); normal weight (BMI <25), overweight (BMI = 25-29.9), and obese (BMI >30)].
methodsIn a randomized, double-blind, practice-based Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial, 33,357 hypertensive participants, aged at least 55 years, were followed for an average of 4.9 years, for a primary outcome of fatal coronary heart disease or nonfatal myocardial infarction, and secondary outcomes of stroke, heart failure, combined cardiovascular disease, mortality, and renal failure.
resultsOf participants, 37.9% were overweight and 42.1% were obese at randomization. For each medication, BP control (<140/90 mmHg) was equivalent in each BMI stratum. At the fifth year, 66.1, 66.5, and 65.1% of normal-weight, overweight, and obese participants, respectively, were controlled. Those randomized to chlorthalidone had highest BP control (67.2, 68.3, and 68.4%, respectively) and to lisinopril the lowest (60.4, 63.2, and 59.6%, respectively) in each BMI stratum. A significant interaction (P = 0.004) suggests a lower coronary heart disease risk in the obese for lisinopril versus chlorthalidone (hazard ratio 0.85, 95% confidence interval 0.74-0.98) and a significant interaction (P = 0.011) suggests a higher risk of end-stage renal disease for amlodipine versus chlorthalidone in obese participants (hazard ratio 1.49, 95% confidence interval 1.06-2.08). However, these results were not consistent among other outcomes.
conclusionBMI status does not modify the effects of antihypertensive medications on BP control or cardiovascular disease outcomes.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.