Effects of Posttrial Antihypertensive Drugs on Morbidity and Mortality: Findings from 15-Year Passive Follow-Up after ALLHAT Ended
Table 4
Adjusted hazard ratio (95% CI) of morbidity and mortality by the end of posttrial (12-31-2017) period.
Total participants N = 8007
Randomization class, non-crossover
1) Diuretic (N = 463 (5.8%))
2) CCB (N = 685 (8.6%))
3) ACE/ARB (N = 1,444 (18.0%))
4) 2 + of diuretic/ CCB/ACE/ARB OR non-RZ class AHTs (N = 4,945 (61.8%))
5) No drugs (N = 470 (5.9%))
ACE/ARB vs CCB (N = 2,129 (26.6%0)
Mortality outcomes
All-cause mortality
1.00 (ref)
1.17 (0.99–1.37)
1.26 (1.09–1.45)
1.08 (0.95–1.23)
1.04 (0.87–1.24)
1.04 (0.92–1.17)
CVD mortality
1.00 (ref)
1.12 (0.87–1.44)
1.29 (1.03–1.61)
1.07 (0.88–1.31)
0.90 (0.68–1.20)
1.10 (0.91–1.33)
CHD mortality
1.00 (ref)
1.25 (0.84–1.85)
1.39 (0.98–1.99)
1.30 (0.94–1.80)
0.98 (0.63–1.54)
0.99 (0.75–1.32)
Stroke mortality
1.00 (ref)
0.91 (0.46–1.77)
1.17 (0.66–2.08)
0.94 (0.57–1.56)
1.00 (0.48–2.09)
1.28 (0.75–2.20)
Heart failure mortality
1.00 (ref)
0.59 (0.27–1.31)
0.88 (0.47–1.65)
0.91 (0.53–1.57)
0.57 (0.24–1.34)
1.31 (0.66–2.57)
Other CVD mortality
1.00 (ref)
1.26 (0.82–1.94)
1.38 (0.94–2.03)
0.94 (0.66–1.33)
0.89 (0.53–1.48)
1.15 (0.83–1.60)
Non-CVD Mortality
1.00 (ref)
1.19 (0.96–1.47)
1.23 (1.01–1.48)
1.08 (0.91–1.28)
1.12 (0.89–1.41)
1.00 (0.85–1.17)
Cancer
1.00 (ref)
1.10 (0.71–1.70)
1.21 (0.83–1.78)
1.01 (0.72–1.43)
1.33 (0.84–2.11)
1.16 (0.82–1.65)
Kidney disease
1.00 (ref)
2.61 (1.04–6.54)
1.44 (0.58–3.59)
1.39 (0.60–3.19)
0.86 (0.25–3.02)
0.55 (0.31–0.95)
Accident/suicide/homicide
1.00 (ref)
0.85 (0.27–2.63)
1.12 (0.43–2.89)
0.97 (0.42–2.28)
0.46 (0.11–1.85)
1.22 (0.50–2.96)
Other non-CVD disease
1.00 (ref)
1.15 (0.88–1.49)
1.22 (0.97–1.54)
1.08 (0.88–1.33)
1.11 (0.83–1.47)
1.01 (0.83–1.22)
Combined fatal and non-fatal hospitalized events
CVD
1.00 (ref)
1.30 (1.04–1.61)
1.49 (1.22–1.81)
1.28 (1.07–1.54)
0.93 (0.71–1.21)
1.06 (0.90–1.24)
CHD
1.00 (ref)
1.31 (0.94–1.81)
1.35 (1.00–1.81)
1.25 (0.96–1.63)
0.93 (0.63–1.36)
0.97 (0.77–1.23)
Heart failure
1.00 (ref)
1.49 (1.14–1.95)
1.69 (1.33–2.16)
1.45 (1.16–1.81)
0.93 (0.67–1.29)
1.08 (0.90–1.30)
Stroke
1.00 (ref)
1.04 (0.69–1.58)
1.60 (1.11–2.29)
1.24 (0.89–1.72)
1.10 (0.68–1.77)
1.38 (1.02–1.87)
Cancer
1.00 (ref)
1.02 (0.73–1.44)
1.07 (0.79–1.44)
0.93 (0.71–1.20)
1.06 (0.73–1.53)
1.07 (0.82–1.41)
Kidney disease/ESRD
1.00 (ref)
3.75 (1.82–7.73)
1.96 (0.95–4.05)
2.07 (1.06–4.05)
2.15 (0.92–5.07)
0.50 (0.34–0.74)
Randomization class indicates on at least a diuretic or CCB or ACE/ARB without class crossover. Abbreviations: ACE/ARB = ACE-inhibitor or alpha receptor blocker; AHT = antihypertensive; CHD = coronary heart disease; CCB = calcium channel blocker; CVD = cardiovascular disease; ESRD = end-stage renal disease. Baseline covariates in the adjusted hazard ratio models include age (years), race (black/non-black), gender, education (years), current smoking status, BMI, entry criterion HDL<35, LDL, GFR, history of diabetes, antihypertensive treatment, on pravastatin, and SBP. In-trial covariate included final SBP.
