We appreciate the favorable comments by Dr Onuigbo on this latest ALLHAT publication.1 We were also impressed by the very positive findings in thiazide-treated patients. ALLHAT was designed to determine whether α-blockers, ACEIs, or CCBs were superior to thiazide-type diuretics (prescribed at an appropriate dosage) as initial therapy for reduction of cardiovascular or renal outcomes.1 While potentially understated, we believe that our overall conclusion that the thiazide-type diuretic was not surpassed is consistent with the data and trial objectives.
Wright JT, Probstfield JL, Cushman WC, Pressel S, Cutler JA, Davis BR, Einhorn PT, Rahman M, Whelton PK, Ford CE, Haywood LJ, Margolis KL, Oparil S, Black HR, Alderman MH, ALLHAT Collaborative Research Group. ALLHAT Findings Revisited in the Context of Subsequent Analyses, Other Trials, and Meta-analyses—Reply. Arch Intern Med. 2009;169(19):1806–1818. doi:10.1001/archinternmed.2009.372