{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T15:42:41Z","timestamp":1790005361958,"version":"4.0.1"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,6]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and objectives<\/jats:title>\n                    <jats:p>CKD is common among older patients. This article assesses long-term renal and cardiovascular outcomes in older high-risk hypertensive patients, stratified by baseline estimated GFR (eGFR), and long-term outcome efficacy of 5-year first-step treatment with amlodipine or lisinopril, each compared with chlorthalidone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, setting, participants, &amp; measurements<\/jats:title>\n                    <jats:p>\n                      This was a long-term post-trial follow-up of hypertensive participants (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      =31,350), aged \u226555 years, randomized to receive chlorthalidone, amlodipine, or lisinopril for 4\u20138 years at 593 centers. Participants were stratified by baseline eGFR (ml\/min per 1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      ) as follows: normal\/increased (\u226590;\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      =8027), mild reduction (60\u201389;\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      =17,778), and moderate\/severe reduction (&lt;60;\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      =5545). Outcomes were cardiovascular mortality (primary outcome), total mortality, coronary heart disease, cardiovascular disease, stroke, heart failure, and ESRD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After an average 8.8-year follow-up, total mortality was significantly higher in participants with moderate\/severe eGFR reduction compared with those with normal and mildly reduced eGFR (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001). In participants with an eGFR &lt;60, there was no significant difference in cardiovascular mortality between chlorthalidone and amlodipine (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.64), or chlorthalidone and lisinopril (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.56). Likewise, no significant differences were observed for total mortality, coronary heart disease, cardiovascular disease, stroke, or ESRD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CKD is associated with significantly higher long-term risk of cardiovascular events and mortality in older hypertensive patients. By eGFR stratum, 5-year treatment with amlodipine or lisinopril was not superior to chlorthalidone in preventing cardiovascular events, mortality, or ESRD during 9-year follow-up. Because data on proteinuria were not available, these findings may not be extrapolated to proteinuric CKD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2215\/cjn.07800811","type":"journal-article","created":{"date-parts":[[2012,4,5]],"date-time":"2012-04-05T22:17:48Z","timestamp":1333664268000},"page":"989-1002","source":"Crossref","is-referenced-by-count":75,"title":["Long-Term Renal and Cardiovascular Outcomes in Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) Participants by Baseline Estimated GFR"],"prefix":"10.2215","volume":"7","author":[{"given":"Mahboob","family":"Rahman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles E.","family":"Ford","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey A.","family":"Cutler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barry R.","family":"Davis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda B.","family":"Piller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul K.","family":"Whelton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jackson T.","family":"Wright","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua I.","family":"Barzilay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clinton D.","family":"Brown","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro J.","family":"Colon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence J.","family":"Fine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard H.","family":"Grimm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alok K.","family":"Gupta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Baimbridge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. 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