0
Editorial |

New-Onset Diabetes Mellitus Less Deadly Than Elevated Blood Pressure?:  Following the Evidence in the Administration of Thiazide Diuretics

Robert A. Phillips, MD, PhD
Arch Intern Med. 2006;166(20):2174-2176. doi:10.1001/archinte.166.20.2174.
Text Size: A A A
Published online

Extract

The primary outcome analysis of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT)1 demonstrated that first-step therapy with a thiazide diuretic was equally effective in reducing major cardiovascular events compared with either a calcium channel blocker (CCB) or angiotensin-converting enzyme (ACE) inhibitor. The results did not bring joy to the pharmaceutical industry, academicians with excessively close ties to the industry, or hypertension specialists wedded to the importance of renin-angiotensin system blockade. The report from the ALLHAT trial in this issue of the ARCHIVES2 will not bring solace to any of these groups. In this retrospective analysis, ALLHAT investigators demonstrate that patients with hypertension who develop diabetes mellitus (DM) while taking thiazide fare better than those who develop DM undergoing treatment with a CCB or ACE inhibitor. The findings of this report make it hard for practitioners and policy makers to shy away from diuretics as first-line therapy for hypertension.

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

References

Correspondence

CME
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 7

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles
Jobs
JAMAevidence.com

Users' Guides to the Medical Literature
Clinical Scenario

Users' Guides to the Medical Literature
Example 1: Diabetes and Target Blood Pressure