Multi-Center Clinical Studies
Impact Public Health
Clinical trials are the definitive way in medicine to evaluate treatment. The Coordinating Center for Clinical Trials runs large multi-center controlled clinical trials that have had a major impact on public health.
The center got its name after the
UT School of Public Health successfully coordinated a nation-wide study of hypertension in
the 1970s. The study, called the Hypertension Detection and
Follow-up Program, resulted in the first aggressive treatment of high blood pressure.
C. Morton Hawkins, Sc.D., principal investigator of the study, became
the first director of the center.
Other major studies followed, involving researchers in many health
centers across America, addressing
health problems such as hyper-tension, heart failure and retinopathy of prematurity.
Landmark Study: Diuretics Treat High Blood Pressure Best
Hypertension, or high blood pressure, is the number one reason adults go to the doctor. Fifty million Americans have hypertension, and it's the single greatest risk factor for diseases of the heart, brain and kidneys.
Treating hypertension is also expensive. Americans spend more than $8 billion a year on blood pressure medications - and even
with treatment, only an estimated
27 percent of patients have
satisfactory results.
That's why recent findings at the UT School of Public Health are making such an impact, garnering front-page headlines across the country and an editorial in The New York Times. The UT School of Public Health's largest,
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most far-reaching study focused on preventing heart attacks and identifying the best treatment
for hypertension. The surprising conclusion: inexpensive
diuretics proved to be a more effective treatment than newer,
costlier drugs.
"This study about blood pressure medications is one of the few ever done showing that a cheaper treatment works as well or better than an expensive one," explains principal investigator Barry R. Davis, M.D., Ph.D., professor and director of the Coordinating Center for Clinical Trials.
The next step is getting the message out about the cheaper, more effective treatment. In an unprecedented step, the NHLBI will spend nearly $4 million
over the next two years to spread the word.
"ALLHAT has brought a lot of interesting results to the medical and scientific communities, a lot of good things to the UT School of Public Health, and it has served as a model for how trials might be done in the future," says Davis.
Ensuring Babies' Sight for
a Lifetime
The UT School of Public Health's Robert J. Hardy, Ph.D., and his fellow-researchers across the country have made giant strides in saving the vision of premature infants.
For the past 20 years Hardy has been involved in major studies
of retinopathy of prematurity (ROP), a leading cause of blindness in children. About two-thirds of premature babies who weigh less than 2.75 pounds will develop the disease, an abnormal growth of blood vessels in the back of the eye. The disease affects an estimated 14,000-16,000 infants in the United States and thousands more worldwide.
| " ALLHAT has brought a
lot of interesting results
to the medical and scientific communities, a lot of
good things to the UT School of Public Health, and it has served as a model for how trials might be done in the future."
Of these preemies, about 1,500 babies each year develop a severe form of the disease, forcing doctors to use laser therapy to burn, or cryotherapy to freeze away, the abnormal blood vessels. The consequence is partial loss of vision.
"The challenge is knowing which babies to treat for ROP and which to keep under observation," explains Hardy, Allan King Professor of Public Health. Now doctors can make a more accurate and earlier prognosis for the disease, thanks to the latest nationwide study headed by Hardy and his team at the Coordinating Center for Clinical Trials. Called Early Treatment for Retinopathy of Prematurity (ETROP), the study demonstrated that preemies retain better vision when therapy is administered early.
The study included developing a risk assessment program using such factors as weight, ethnicity, and single or multiple birth babies to help doctors make an earlier, better diagnosis. "It shows that you can identify high-risk babies and treat them and further lower their risk of blindness," says Hardy. "Now the rate of blindness with treatment is very low. Until now, we didn't know that earlier intervention would help."
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