Introduction
CHD, nonfatal myocardial infarction
EVENTS, CORONARY HEART DISEASE, HEART ATTACK
The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) was a multicenter, randomized, double-blind, active-controlled clinical trial comparing initial antihypertensive treatment with a calcium channel blocker (amlodipine), an angiotensin-converting enzyme inhibitor (lisinopril), or an α-blocker (doxazosin), all compared with a thiazide-type diuretic (chlorthalidone) for the composite outcome of fatal coronary heart disease (CHD) or nonfatal myocardial infarction (MI).A previous study reported mortality and morbidity outcomes of ALLHAT participants during 8 to 13 years after randomization using in-trial data plus posttrial data from administrative databases to assess the long-term effects of first-step antihypertensive treatment.We linked the data to obtain an additional 11 years of passive administrative data since the last report, for a total of 19 to 24 years of follow-up after randomization. We aimed to determine whether the aforementioned legacy effects (ie, the observed in-trial differences) persisted after the trial and whether the increase in the incidence of events resulting from longer follow-up led to sufficient power to detect differences among the randomization groups.