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ALLHAT rannsóknin : á að setja alla blóðþrýstingsmeðferð undir sama hatt? [ritstjórnargrein]

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Authors
Karl Andersen
Issue Date
2003-03-01

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Other Titles
BP management. Lessons from ALLHAT [editorial]
Citation
Læknablaðið 2003, 89(3):183-184
Abstract
Að undanförnu hefur mikið verið rætt um vaxandi kostnað ríkisins vegna lyfjanotkunar landsmanna. Almennt er litið á kostnaðaraukningu sem vandamál sem takast þarf á við og beinast þá spjótin oftar en ekki gegn læknum og því hvernig þeir velja lyf handa skjólstæðingum sínum. Í lok síðasta árs voru niðurstöður ALLHAT rannsóknarinnar birtar í JAMA (1) og hafa orðið tilefni til mikillar umræðu um hvernig standa skuli að lyfjameðferð við háþrýstingi. Í rannsókninni var um 42.000 bandarískum háþrýstingssjúklingum eldri en 55 ára, slembiraðað í fjóra hópa sem fengu blindaða meðferð með annaðhvort chlorthalidone (þíazíð þvagræsilyf), amlodipin (kalsíum blokkari), lisinopril (ACE blokkari) eða doxazocin (alfa blokkari). Reyndist þessi grunnmeðferð ekki árangursrík var leyft að bæta við opinni meðferð með reserpin, klonidin eða atenolol. Reyndist sú meðferð ekki nægileg var enn möguleiki á að bæta við hydralazini. Meðferðartíminn var að meðaltali 4,9 ár, meðalaldur 67 ár, karlar og konur með grunngildi blóðþrýstings 146/84 mmHg.
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