January 24, 2003
Mr. Andrew Liebman
Producer, Resolute Films
119 Braintree Street, Suite 410
Boston, MA 02134
Dear Mr. Liebman:
Thank you for your interest in the ALLHAT trial. We disagree with the claims outlined in your letter and believe they oversimplify the challenges physicians face in managing hypertension, which is a complex disease that remains vastly under-treated.
High blood pressure is a medical condition that affects more than 50 million Americans and is a leading risk factor for heart disease—the No. 1 cause of death in the U.S. Despite the abundance of available therapies, the majority of patients are not at their recommended blood pressure goals.
The ALLHAT study was designed to examine the effects of two of the most commonly used anti-hypertensives compared to a diuretic in reducing heart disease for patients with high blood pressure.
The results support current treatment guidelines that outline how a physician should manage high blood pressure. These guidelines recommend initiating treatment with diuretics and, if needed, adding additional medications until patients reach their recommended blood pressure goals.
Specific to the ALLHAT study, it is critical to note that:
Norvasc (amlodpine besylate) was shown to be safe and effective in reducing cardiovascular morbidity and mortality at rates similar to the diuretic chlorthalidone. However, to suggest that chlorthalidone is clinically superior to Norvasc in [sic] not supported by the data.
More than 60% of the patients in the study needed two or more medications to achieve their blood pressure goals. It would be irresponsible to suggest that all patients can be managed with only a diuretic.
What has been missing in the coverage of ALLHAT is the importance of blood pressure control in reducing long-term cardiovascular events such as heart attack, stroke and death. That is our message for Norvasc, and we strongly believe this message is a positive message for public health.
Michael Berelowitz, M.D.
Cardiovascular and Metabolic Group