Speaker's Remarks

December 17, 2002

Press Conference Remarks

Release of the Results of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial

Good morning. Today we will present to you the findings of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial--known as ALLHAT.

ALLHAT is the largest hypertension or high blood pressure trial ever conducted. It was designed to compare the drugs for use in starting treatment for high blood pressure - specifically traditional thiazide-type diuretics versus newer, more costly blood pressure-lowering drugs: calcium channel blockers, ACE inhibitors, and alpha-adrenergic blockers. Findings from the alpha blocker arm of the study were reported after that arm of the study was stopped in March 2000. Today we will report on the results comparing the diuretic to a calcium channel blocker and to an ACE inhibitor.

The ALLHAT study has important public health implications: about 50 million Americans have high blood pressure, which is a risk factor for heart attack and the chief risk factor for heart failure and stroke.

ALLHAT also included a cholesterol-lowering study that compared the effects of a statin drug and cholesterol-lowering diet with "usual care." About 65 million American adults have high blood cholesterol levels that require medical attention. High blood cholesterol is a major risk factor for coronary heart disease, the number one cause of death in the U.S.

Before we present the cholesterol and hypertension results, I would like to announce that I am appointing a committee to produce a seventh report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure--known as JNC 7. The Committee will be chaired by Dr. Aram Chobanian, Dean of Boston University Medical School and Provost of Boston University Medical Center. JNC 7 will develop new clinical guidelines for high blood pressure. The report will incorporate findings from ALLHAT and other recent clinical trials in order to inform and help guide busy practicing clinicians. We are deeply committed to applying these research findings in order to improve the health of the nation.

Now I would like to thank the over 600 principal investigators of ALLHAT for their dedication and involvement in this important study. Thanks also go to the more than 42,000 ALLHAT participants without whom this trial could not have been done. I also wish to acknowledge the contribution of the NHLBI project office, particularly the dedication of Dr. Jeff Cutler, in oversight and management of this trial.

Finally, I would like to thank our speakers, all of whom are members of the ALLHAT Steering Committee, as well as dedicated scientists and physicians.

Our first speaker today is Dr. Barry Davis, Director and Principal Investigator of the ALLHAT Clinical Trials Center. Dr. Davis is also Professor of Biometry at the University of Texas School of Public Health in Houston. Dr Davis will discuss the background, purpose, and study design of ALLHAT. Our second speaker will be Dr. Curt Furberg, professor of public health sciences at Wake Forest University Baptist Medical Center. Dr. Furberg will describe the unique nature of ALLHAT. Then we will hear from Dr. Jackson Wright, vice chair of the ALLHAT Steering Committee and Professor of Medicine, Case Western Reserve University.

Dr. Wright will report on the hypertension results. He will be followed by Dr. Jeffrey Probstfield of the ALLHAT Steering Committee, director, Clinical Trials Service Unit at the University of Washington Health Sciences Center. Dr. Probstfield will discuss the lipid lowering trial results. Our final speaker will be Dr. Paul Whelton of the ALLHAT Steering Committee. Dr. Whelton, a professor of epidemiology and medicine at Tulane University Health Sciences Center, will discuss the implications of ALLHAT for patients and physicians. Following Dr. Whelton's presentation, we will be happy to answer your questions.

Dr. Davis...