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Bruce Arroll, Henry Wallace
INTRODUCTION Thiazide diuretics are commonly prescribed in the treatment of hypertension. However, thiazide diuretics may not all be equal in their ability to reduce cardiovascular disease outcomes. AIM To determine if bendroflumethiazide/bendrofluazide, the most commonly used diuretic for hypertension in New Zealand, is as effective as other diuretics in terms of cardiovascular disease outcomes. METHODS Using recent reviews of thiazide-like (chlorthalidone or indapamide) and thiazide-type diuretics (hydrochlorothiazide and bendrofluazide) and a separate search of bendrofluazide, data on cardiovascular disease outcomes was extracted...
June 2017: Journal of Primary Health Care
Sonal Singh, Caitrin W McDonough, Yan Gong, Wael A Alghamdi, Meghan J Arwood, Salma A Bargal, Leanne Dumeny, Wen-Yi Li, Mai Mehanna, Bradley Stockard, Guang Yang, Felipe A de Oliveira, Natalie C Fredette, Mohamed H Shahin, Kent R Bailey, Amber L Beitelshees, Eric Boerwinkle, Arlene B Chapman, John G Gums, Stephen T Turner, Rhonda M Cooper-DeHoff, Julie A Johnson
BACKGROUND: Thiazide and thiazide-like diuretics are first-line medications for treating uncomplicated hypertension. However, their use has been associated with adverse metabolic events, including hyperglycemia and incident diabetes mellitus, with incompletely understood mechanisms. Our goal was to identify genomic variants associated with thiazide-like diuretic/chlorthalidone-induced glucose change. METHODS AND RESULTS: Genome-wide analysis of glucose change after treatment with chlorthalidone was performed by race among the white (n=175) and black (n=135) participants from the PEAR-2 (Pharmacogenomic Evaluation of Antihypertensive Responses-2)...
March 9, 2018: Journal of the American Heart Association
Ravi Tejraj Mehta, Anil Pareek, Indranil Purkait
We have read the study design "Comparison of effects between calcium channel blocker and diuretics in combination with angiotensin II receptor blocker on 24-h central blood pressure and vascular hemodynamic parameters in hypertensive patients: study design for a multicenter, double-blinded, active controlled, phase 4, randomized trial" by Oh GC, et al. with interest. The authors aim to compare the efficacy of amlodipine or hydrochlorothiazide (HCTZ) with an ARB. However, we wish to highlight that chlorthalidone (CTD) is the evidence-based and recommended anti-hypertensive diuretic, and should replace HCTZ in the trial to effectively compare efficacy against the CCB amlodipine...
2018: Clinical Hypertension
George L Bakris, Lin Zhao, Stuart Kupfer, Attila Juhasz, Michie Hisada, Eric Lloyd, Suzanne Oparil
An open-label, long-term study evaluated safety and tolerability of azilsartan medoxomil/chlorthalidone (AZL-M/CLD) vs olmesartan/hydrochlorothiazide (OLM/HCTZ) in hypertensive participants with stage 3 chronic kidney disease. Initial therapy was AZL-M/CLD 20/12.5 mg (n = 77) or OLM/HCTZ 20/12.5 mg (n = 76), but could be up-titrated (AZL-M/CLD to 40/25 mg; OLM/HCTZ to 40/25 mg [US] or 20/25 mg [Europe]) with other agents added during weeks 4-52. Primary endpoint was proportion of participants with ≥ 1 adverse event (AE) through week 52...
March 4, 2018: Journal of Clinical Hypertension
Walter M van der Merwe
No abstract text is available yet for this article.
March 4, 2018: Journal of Clinical Hypertension
Jiří Slíva
Thiazide and thiazide-like diuretics are an important group of drugs used in the treatment of essential arterial hyper-tension. While their beneficial therapeutic effect in monotherapy is evident, they are increasingly used in fixed combinations, particularly with ACE inhibitors or sartans. The aim of this article was to summarize the current status of hydrochlorothiazide and compare its effects with other substances in this subgroup of diuretics.Key words: diuretics - HCTZ - hydrochlorothiazide - hypertension - chlorthalidone - indapamide - thiazide...
2018: Vnitr̆ní Lékar̆ství
George C Roush, Ramy Abdelfattah, Steven Song, John B Kostis, Michael E Ernst, Domenic A Sica
BACKGROUND: Found in 36-41% of hypertension, elevated left ventricular mass (LVM) independently predicts cardiovascular events and total mortality. Conversely, drug-induced regression of LVM predicts improved outcomes. Previous studies have favored renin-angiotensin system inhibitors (RASIs) over other antihypertensives for reducing LVM but ignored differences among thiazide-type diuretics. From evidence regarding potency, cardiovascular events, and electrolytes, we hypothesized a priori that 'CHIP' diuretics [CHlorthalidone, Indapamide and Potassium-sparing Diuretic/hydrochlorothiazide (PSD/HCTZ)] would rival RASIs for reducing LVM...
February 20, 2018: Journal of Hypertension
André J Scheen
PURPOSE OF REVIEW: In patients with prediabetes or type 2 diabetes, the use of thiazides as antihypertensive agents has been challenged because associated metabolic adverse events, including new-onset diabetes. RECENT FINDINGS: These metabolic disturbances are less marked with low-dose thiazides and, in most but not all studies, with thiazide-like diuretics (chlorthalidone, indapamide) than with thiazide-type diuretics (hydrochlorothiazide). In post hoc analyses of subgroups of patients with hypertension and type 2 diabetes, thiazides resulted in a significant reduction in cardiovascular events, all-cause mortality, and hospitalization for heart failure compared to placebo and generally were shown to be non-inferior to other antihypertensive agents...
February 5, 2018: Current Diabetes Reports
Joshua I Barzilay, Barry R Davis, Sara L Pressel, Alokananda Ghosh, Mahboob Rahman, Paula T Einhorn, William C Cushman, Paul K Whelton, Jackson T Wright
BACKGROUND: Impaired renal function is a risk factor for cardiovascular disease, end-stage renal disease (ESRD), and mortality. The impact of short-term renal function decline on outcomes is less well studied. The association of antihypertensive medications with the impact of short-term estimated glomerular filtration rate (eGFR) decline is not known. METHODS: We examined 20,207 hypertensive participants with baseline and 2-year creatinine levels from which eGFR changes were estimated...
January 19, 2018: American Journal of Hypertension
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
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
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...
April 2018: Journal of Hypertension
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
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
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
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
Maria Terezinha França, Rafael Nicolay Pereira, 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...
January 1, 2018: European Journal of Pharmaceutical Sciences
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...
December 2017: Journal of Clinical Hypertension
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
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
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