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To the Editor: Antihypertensive agents are among the most commonly prescribed medications for elderly persons in North America.¹ The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT), published on December 18, 2002, concluded that thiazide-type diuretics should be the first-step antihypertensive therapy, compared with either calcium channel blockers (CCBs) or angiotensin-converting enzyme (ACE) inhibitors.² We examined trends in incident use of antihypertensive agents following publication of the ALLHAT trial.

Methods

We studied claims for antihypertensive agents that were submitted to the Ontario Drug Benefit (ODB) program between January 1, 1992, and April 30, 2003. The ODB program tracks prescriptions dispensed to all 1.3 million residents of Ontario older than 65 years. We examined claims for the following classes of antihypertensive agents: thiazide-type diuretics, CCBs, -blockers, and ACE inhibitors or angiotensin receptor blockers. For each month of each year, we determined the number of prescriptions filled by patients who had . . . [Full Text of this Article]

Peter C. Austin, PhD; Muhammad M. Mamdani, PharmD, MA, MPH; Karen Tu, MD, MSc, CCFP; Merrick Zwarenstein, MB, BCh, MSc(Med), MSc
Institute for Clinical Evaluative Sciences
Toronto, Ontario

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