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Chlorthalidone

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https://www.readbyqxmd.com/read/29334491/a-randomized-titrate-to-target-study-comparing-fixed-dose-combinations-of-azilsartan-medoxomil-and-chlorthalidone-with-olmesartan-and-hydrochlorothiazide-in-stage-2-systolic-hypertension
#1
William C Cushman, George L Bakris, William B White, Michael A Weber, Domenic Sica, Andrew Roberts, Eric Lloyd, Stuart Kupfer
BACKGROUND: Azilsartan medoxomil (AZL-M), an angiotensin II receptor blocker, has been developed in fixed-dose combinations (FDCs) with chlorthalidone (CTD). OBJECTIVE/METHODS: We compared FDCs of AZL-M/CTD 20/12.5 mg once daily titrated to 40/25 mg if needed or AZL-M/CTD 40/12.5 mg once daily titrated to 80/25 mg if needed with an olmesartan medoxomil (OLM)-hydrochlorothiazide (HCTZ) 20/12.5 mg FDC once daily titrated to 40/25 mg if needed in a randomized, double-blind, 8-week study of 1085 participants with clinic SBP 160-190 mmHg and DBP 119 mmHg or less...
January 13, 2018: Journal of Hypertension
https://www.readbyqxmd.com/read/29276912/-antihypertensive-efficacy-of-fixed-combination-azilsartan-medoxomil-chlorthalidone-in-patients-with-uncontrolled-arterial-hypertension
#2
Z D Kobalava, S V Villevalde, V V Kulakov
AIM: To study effects of a fixed azilsartan medoxomil/chlorthalidone combination (Edarbi Clo) on clinical, ambulatory and central blood pressure (BP) in patients with uncontrolled arterial hypertension (AH)). MATERIALS AND METHODS: Patients (n=25) with uncontrolled AH were given fixed azilsartan medoxomil/chlorthalidone combination (40 / 12.5 mg / day) for 4 weeks. After 4 weeks, in patients who did not achieve target BP levels the dose was increased up to 40 / 25 mg / day...
November 2017: Kardiologiia
https://www.readbyqxmd.com/read/29227377/effectiveness-of-low-dose-diuretics-for-blood-pressure-reduction-to-optimal-values-in-prehypertension-a-randomized-clinical-trial
#3
Flávio D Fuchs, Sandra C Fuchs, Carlos E Poli-de-Figueiredo, José A Figueiredo Neto, Luiz César N Scala, José F Vilela-Martin, Leila B Moreira, Hilton Chaves, Marco Mota Gomes, Marcos R de Sousa, Ricardo Pereira E Silva, Iran Castro, Evandro José Cesarino, Ana Luiza Lima Sousa, João Guilherme Alves, André Avelino Steffens, Andréa Araujo Brandão, Luiz Aparecido Bortolotto, Abrahão Afiune Neto, Antônio C Nóbrega, Roberto Silva Franco, Dario C Sobral Filho, Fernando Nobre, Rosane Schlatter, Miguel Gus, Caroline Nespolo De David, Leticia Rafaelli, Guilhermo Prates Sesin, Otávio Berwanger, Paul K Whelton
BACKGROUND: To determine the effectiveness of low-dose diuretic therapy to achieve an optimal level of blood pressure (BP) in adults with prehypertension. METHODS: The PREVER-prevention trial was a randomized, parallel, double-blinded, placebo-controlled trial, with 18 months of follow-up, conducted at 21 academic medical centers in Brazil. Of 1772 individuals evaluated for eligibility, 730 volunteers with prehypertension who were aged 30-70 years, and who did not reach optimal blood pressure after 3 months of lifestyle intervention, were randomized to a fixed association of chlorthalidone 12...
December 7, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/29212812/pharmacologic-prevention-of-incident-atrial-fibrillation-long-term-results-from-the-allhat-antihypertensive-and-lipid-lowering-treatment-to-prevent-heart-attack-trial
#4
RANDOMIZED CONTROLLED TRIAL
Thomas A Dewland, Elsayed Z Soliman, Jose-Miguel Yamal, Barry R Davis, Alvaro Alonso, Christine M Albert, Lara M Simpson, L Julian Haywood, Gregory M Marcus
BACKGROUND: Although atrial fibrillation (AF) guidelines indicate that pharmacological blockade of the renin-angiotensin system may be considered for primary AF prevention in hypertensive patients, previous studies have yielded conflicting results. We sought to determine whether randomization to lisinopril reduces incident AF or atrial flutter (AFL) compared with chlorthalidone in a large clinical trial cohort with extended post-trial surveillance. METHODS AND RESULTS: We performed a secondary analysis of the ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial), a randomized, double-blind, active-controlled clinical trial that enrolled hypertensive individuals ≥55 years of age with at least one other cardiovascular risk factor...
December 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29167564/whole-transcriptome-sequencing-analyses-reveal-molecular-markers-of-blood-pressure-response-to-thiazide-diuretics
#5
Ana Caroline C Sá, Amy Webb, Yan Gong, Caitrin W McDonough, Somnath Datta, Taimour Y Langaee, Stephen T Turner, Amber L Beitelshees, Arlene B Chapman, Eric Boerwinkle, John G Gums, Steven E Scherer, Rhonda M Cooper-DeHoff, Wolfgang Sadee, Julie A Johnson
Thiazide diuretics (TD) are commonly prescribed anti-hypertensives worldwide. However, <40% of patients treated with thiazide monotherapy achieve BP control. This study uses whole transcriptome sequencing to identify novel molecular markers associated with BP response to TD. We assessed global RNA expression levels in whole blood samples from 150 participants, representing patients in the upper and lower quartile of BP response to TD from the Pharmacogenomic Evaluation of Antihypertensive Responses (PEAR) (50 whites) and from PEAR-2 (50 whites and 50 blacks)...
November 22, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29036504/echocardiographic-left-ventricular-reverse-remodeling%C3%A2-after-18-months-of-antihypertensive-treatment-in-stage-i-hypertension-results-from-the-prever-treatment-study
#6
C Bertoluci, M Foppa, A B S Santos, T V Branchi, S C Fuchs, F D Fuchs
Background: Antihypertensive treatment improves echocardiographic parameters of hypertensive target organ damage in stage II hypertension, but less is known about the effects in stage I hypertension. Methods: In a cohort study nested in the randomized double-blind trial PREVER-treatment, two-dimensional echocardiograms were performed in 110 individuals, aged 54.8 ± 7.9 years-old, with stage I hypertension at baseline and after 18 months of treatment with chlorthalidone/amiloride or losartan...
September 27, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/28987246/influence-of-prevalent-and-incident-atrial-fibrillation-on-post-trial-major-events-in-allhat
#7
L Julian Haywood, Barry R Davis, Linda B Piller, William C Cushman, Jeffrey A Cutler, Charles E Ford, Lara M Simpson, Alokananda Ghosh, Elsayed Z Soliman, Jackson T Wright
AIMS: Limited information is available on long-term antihypertensive and lipid-lowering therapy effects on hypertensive patients with atrial fibrillation/flutter (AF/AFL) compared to those without. AF/AFL at baseline or during the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) (mean follow-up 4.9 years) markedly increased risk of stroke, heart failure, CHD, and all-cause mortality. We aimed to determine if AF/AFL continued to impact outcomes during post-trial follow-up (mean 3...
2017: Journal of the National Medical Association
https://www.readbyqxmd.com/read/28964949/investigation-of-novel-supersaturating-drug-delivery-systems-of-chlorthalidone-the-use-of-polymer-surfactant-complex-as-an-effective-carrier-in-solid-dispersions
#8
Maria Terezinha França, Rafael Pereira Nicolay, Manoela Klüppel Riekes, Juliana Munari Oliveira Pinto, Hellen Karine Stulzer
Supersaturating drug delivery systems (SDDS), as solid dispersions (SDs), stand out among strategies to enhance bioavailability of poorly soluble drugs. After oral administration, their dissolution in gastrointestinal fluids often leads to supersaturation, which drives to a rapid and sustained absorption. Polymers and surfactants play important roles in SDs through inhibiting precipitation caused by transitions from amorphous into crystalline form, in supersaturated solutions, and also through improving SDs physical stability...
September 28, 2017: European Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28940643/blood-pressure-response-to-metoprolol-and-chlorthalidone-in-european-and-african-americans-with-hypertension
#9
Mai Mehanna, Yan Gong, Caitrin W McDonough, Amber L Beitelshees, John G Gums, Arlene B Chapman, Gary L Schwartz, Julie A Johnson, Stephen T Turner, Rhonda M Cooper-DeHoff
Despite the availability of many antihypertensive drug classes, half of patients with hypertension have uncontrolled blood pressure (BP). The authors sought to assess the effect of age on BP response in European American and African American patients with hypertension. Clinic BP from the PEAR2 (Pharmacogenomics Evaluation of Antihypertensive Responses 2) study was used to estimate BP responses from baseline following sequential treatment with metoprolol 100 mg twice daily and chlorthalidone 25 mg daily for 8 to 9 weeks each, with a minimum 4-week washout between treatments...
September 21, 2017: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/28939406/comparison-of-fixed-dose-combinations-of-amlodipine-losartan-potassium-chlorthalidone-and-amlodipine-losartan-potassium-in-patients-with-stage-2-hypertension-inadequately-controlled-with-amlodipine-losartan-potassium-a-randomized-double-blind-multicenter-phase
#10
Soon Jun Hong, Han Saem Jeong, Seung Hwan Han, Ki Yuk Chang, Bum Kee Hong, Bong Ki Lee, Shung Chull Chae, Woo Shik Kim, Chang Gyu Park, Jung Ho Heo, Seung Uk Lee, Young Dae Kim, Kee Sik Kim, Jung Hyun Choi, Hyun Jae Kang, Jae Joong Kim, Seok Min Kang, Young Jin Choi, Joon Han Shin, Kook Jin Chun, Dong Gu Shin, Seong Hoon Park, Jun Kwan, Yu Jeong Choi, Myung Ho Jeong, Jei Keon Chae, Dong Woon Kim, Jung Rae Cho, Kyoo Rok Han, Kyung Heon Won, Sang Ho Park, Sang Kon Lee, Sang Hoon Kim, Jina Jung, Cheol Ho Kim
PURPOSE: The goal of this study was to compare the efficacy and safety of fixed-dose combinations of amlodipine/losartan potassium/chlorthalidone (A/L/C) and A/L in Korean patients with stage 2 hypertension inadequately controlled by A/L. METHODS: This study was an 8-week, randomized double-blind, multicenter, phase III clinical trial. Three hundred forty volunteer patients with stage 2 hypertension were randomized to receive A/L/C or A/L. The primary end point was a change in sitting systolic blood pressure (SitSBP) after 8 weeks of treatment...
September 19, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28888268/a-randomized-multicenter-open-label-blinded-end-point-trial-comparing-the-effects-of-spironolactone-to-chlorthalidone-on-left-ventricular-mass-in-patients-with-early-stage-chronic-kidney-disease-rationale-and-design-of-the-spiro-ckd-trial
#11
RANDOMIZED CONTROLLED TRIAL
Manvir K Hayer, Nicola C Edwards, Gemma Slinn, William E Moody, Rick P Steeds, Charles J Ferro, Anna M Price, Cecilio Andujar, Mary Dutton, Rachel Webster, David J Webb, Scott Semple, Iain MacIntyre, Vanessa Melville, Ian B Wilkinson, Thomas F Hiemstra, David C Wheeler, Anna Herrey, Margaret Grant, Samir Mehta, Natalie Ives, Jonathan N Townend
BACKGROUND: Chronic kidney disease (CKD) is associated with increased left ventricular (LV) mass and arterial stiffness. In a previous trial, spironolactone improved these end points compared with placebo in subjects with early-stage CKD, but it is not known whether these effects were specific to the drug or secondary to blood pressure lowering. AIM: The aim was to investigate the hypothesis that spironolactone is superior to chlorthalidone in the reduction of LV mass while exerting similar effects on blood pressure...
September 2017: American Heart Journal
https://www.readbyqxmd.com/read/28868298/case-report-of-spontaneous-remission-of-biopsy-proven-idiopathic-immune-complex-mediated-membranoproliferative-glomerulonephritis
#12
Rehan Shah, Mark S Segal, Michael J Wilkowski
Membranoproliferative glomerulonephritis (MPGN) is a histopathologic diagnosis causing microscopic hematuria, nephrotic range proteinuria, and chronic renal failure. Current understanding divides pathogenesis into two broad categories: immune complex mediated and complement mediated (now termed C3 glomerulopathy). The term idiopathic immune complex-mediated MPGN would apply to a patient without an identifiable source of immune complex production and no evidence of C3 glomerulopathy. Presented is a patient with idiopathic immune complex mediated MPGN and her clinical course...
May 2017: Case Reports in Nephrology and Dialysis
https://www.readbyqxmd.com/read/28811176/bullous-fixed-drug-eruption-secondary-to-chlorthalidone
#13
Nathaly Cuervo-Pardo, Aurora Gonzalez-Estrada, Lyda Cuervo-Pardo, Keerthi Reddy, Alexei Gonzalez-Estrada
No abstract text is available yet for this article.
August 12, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28711447/the-transition-from-hypertension-to%C3%A2-heart%C3%A2-failure-contemporary-update
#14
REVIEW
Franz H Messerli, Stefano F Rimoldi, Sripal Bangalore
Longstanding hypertension ultimately leads to heart failure (HF), and as a consequence most patients with HF have a history of hypertension. Conversely, absence of hypertension in middle age is associated with lower risks for incident HF across the remaining life course. Cardiac remodeling to a predominant pressure overload consists of diastolic dysfunction and concentric left ventricular (LV) hypertrophy. When pressure overload is sustained, diastolic dysfunction progresses, filling of the concentric remodeled LV decreases, and HF with preserved ejection fraction ensues...
July 6, 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/28696223/white-coat-effect-is-uncommon-in-patients-with-refractory-hypertension
#15
Mohammed Siddiqui, Eric K Judd, Suzanne Oparil, David A Calhoun
Refractory hypertension is a recently described phenotype of antihypertensive treatment failure defined as uncontrolled blood pressure (BP) despite the use of ≥5 different antihypertensive agents, including chlorthalidone and spironolactone. Recent studies indicate that refractory hypertension is uncommon, with a prevalence of ≈5% to 10% of patients referred to a hypertension specialty clinic for uncontrolled hypertension. The prevalence of white-coat effect, that is, uncontrolled automated office BP ≥135/85 mm Hg and controlled out-of-office BP <135/85 mm Hg, by awake ambulatory BP monitor in hypertensive patients overall is ≈30% to 40%...
September 2017: Hypertension
https://www.readbyqxmd.com/read/28681550/comparison-of-long-term-safety-of-fixed-dose-combinations-azilsartan-medoxomil-chlorthalidone-vs-olmesartan-medoxomil-hydrochlorothiazide
#16
Joel M Neutel, William C Cushman, Eric Lloyd, Bruce Barger, Alison Handley
This 52-week, randomized, open-label study evaluated long-term safety/tolerability of fixed-dose combination azilsartan medoxomil/chlorthalidone (AZL-M/CLD) vs fixed-dose combination olmesartan medoxomil/hydrochlorothiazide (OLM/HCTZ) in patients with essential hypertension (stage 2; clinic systolic blood pressure 160-190 mm Hg). Initial AZL-M/CLD 40/12.5 mg/d (n=418) or OLM/HCTZ 20/12.5 mg/d (n=419) could be uptitrated during weeks 4 to 52 (AZL-M/CLD to 80/25 mg; OLM/HCTZ to 40/25 mg [United States] or 20/25 mg [Europe]) to meet blood pressure targets...
July 6, 2017: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/28676030/heart-failure-with-preserved-ejection-fraction-a-dilemma-in-treatment-options
#17
Taylor Bramblett, Mohamed Teleb, Aymen Albaghdadi, Harsh Agrawal, Debabrata Mukherjee
Heart failure with preserved ejection fraction (HFpEF) makes up half of diagnosed heart failure cases and has similar outcomes compared to heart failure with reduced ejection fraction (HFrEF) but a discrepancy in knowledge and approach to treatment. HFpEF is diagnosed using the following criteria: symptoms, preserved ejection fraction (greater than 50%), and evidence of abnormal left ventricular filling or relaxation, or diastolic distensibility or stiffness. Studies conducted to examine the efficacy of angiotensin receptor blockers (irbesartan and candesartan), thiazide diuretics (chlorthalidone), and angiotensin converting enzyme inhibitors (perindopril) in the treatment of HFpEF, showed moderate efficacy but no clear benefit...
July 3, 2017: Cardiovascular & Hematological Disorders Drug Targets
https://www.readbyqxmd.com/read/28631393/comparison-of-thiazide-like-diuretics-versus-thiazide-type-diuretics-a-meta-analysis
#18
REVIEW
Wenjing Liang, Hui Ma, Luxi Cao, Wenjiang Yan, Jingjing Yang
Thiazide diuretics are widely used for the management of hypertension. In recent years, it has been actively debated that there is interchangeability of thiazide-type diuretics hydrochlorothiazide and thiazide-like diuretics including indapamide and chlorthalidone for the treatment of hypertension. With the purpose of seeking out the best thiazide diuretic for clinicians, we summarized the existing evidence on the two types of drugs and conducted a meta-analysis on their efficacy in lowering blood pressure and effects on blood electrolyte, glucose and total cholesterol...
November 2017: Journal of Cellular and Molecular Medicine
https://www.readbyqxmd.com/read/28559399/heterogeneity-in-early-responses-in-allhat-antihypertensive-and-lipid-lowering-treatment-to-prevent-heart-attack-trial
#19
RANDOMIZED CONTROLLED TRIAL
Sanket S Dhruva, Chenxi Huang, Erica S Spatz, Andreas C Coppi, Frederick Warner, Shu-Xia Li, Haiqun Lin, Xiao Xu, Curt D Furberg, Barry R Davis, Sara L Pressel, Ronald R Coifman, Harlan M Krumholz
Randomized trials of hypertension have seldom examined heterogeneity in response to treatments over time and the implications for cardiovascular outcomes. Understanding this heterogeneity, however, is a necessary step toward personalizing antihypertensive therapy. We applied trajectory-based modeling to data on 39 763 study participants of the ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial) to identify distinct patterns of systolic blood pressure (SBP) response to randomized medications during the first 6 months of the trial...
July 2017: Hypertension
https://www.readbyqxmd.com/read/28430947/electrocardiographic-left-ventricular-hypertrophy-predicts-cardiovascular-morbidity-and-mortality-in-hypertensive-patients-the-allhat-study
#20
Casper N Bang, Elsayed Z Soliman, Lara M Simpson, Barry R Davis, Richard B Devereux, Peter M Okin
BACKGROUND: Electrocardiographic (ECG) left ventricular hypertrophy (LVH) is a strong predictor of cardiovascular (CV) morbidity and mortality. However, the predictive value of ECG LVH in treated hypertensive patients remains unclear. METHODS: A total of 33,357 patients (aged ≥ 55 years) with hypertension and at least 1 other coronary heart disease (CHD) risk factor were randomized to chlorthalidone, amlodipine, or lisinopril. The outcome of the present study was all-cause mortality; and secondary endpoints were CHD, nonfatal myocardial infarction (MI), stroke, angina, heart failure (HF), and peripheral arterial disease...
September 1, 2017: American Journal of Hypertension
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