Landmark hypertension study launches extensive physician and patient education program

of the study was stopped early.

"Based on the results, the ALLHAT investigators recommend that in addition to lifestyle changes, diuretics should be the drug of choice for first line blood pressure treatment," says William C. Cushman, MD, chair of the ALLHAT Dissemination Committee and chief of Preventive Medicine at the Veterans Affairs Medical Center in Memphis. "Because most patients require more than one drug, diuretics should generally be part of any antihypertensive regimen."

Cushman cites another advantage for using diuretics. "They are much less expensive than the other two drug classes. For those stretching their budgets, taking a medicine which costs less than $100 a year is a very good thing."

In the past 20 years, however, prescriptions for newer, more costly medications began replacing diuretics. The newer drugs were shown to lower blood pressure and heart disease risk compared to placebo, but how the drugs compared to each other was unknown until ALLHAT. Analyses of prescribing trends suggest that prescriptions for diuretics have slowly begun to rise since the study ended and clinical guidelines have encouraged the use of diuretics either alone or in combination with other blood-pressure lowering medications.

"The guidelines were simplified and strengthened to emphasize the most effective ways to control blood pressure starting with lifestyle changes and including diuretics when medication is needed," notes Jeffrey Cutler, MD, NHLBI senior advisor and ALLHAT project director.

The ALLHAT Dissemination Plan includes materials for investigator educators to lead small, interactive educational sessions with physician peers. Educators are asked to make at least one presentation per month. The sessions include discussions of the study results, current hypertension treatment guidelines, and common concerns in clinical practice. Each educator receives training, presentation slides and handouts, and materials such as po

Contact: NHLBI Communications Office
NIH/National Heart, Lung, and Blood Institute

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