Produção Nacional
Revisado por pares
Effectiveness of low-dose diuretics for blood pressure reduction to optimal values in prehypertension
2017; Lippincott Williams & Wilkins; Volume: 36; Issue: 4 Linguagem: Inglês
10.1097/hjh.0000000000001624
ISSN1473-5598
AutoresFlávio Danni Fuchs, Sandra Cristina Pereira Costa Fuchs, Carlos Eduardo Poli‐de‐Figueiredo, José Albuquerque de Figueiredo Neto, Luiz César Nazário Scala, José Fernando Vilela-Martin, Leila Beltrami Moreira, Hilton Chaves, Marco Mota Gomes, Marcos Roberto de Sousa, Ricardo Pereira e Silva, Iran Castro, Evandro José Cesarino, Ana Luíza Lima Sousa, João Guilherme Bezerra Alves, André Avelino Steffens, Andréa Araújo Brandão, Luiz Aparecido Bortolotto, Abrahão Afiune Neto, Antônio Cláudio Lucas da Nóbrega, Roberto Silva Franco, Dário Celestino Sobral Filho, Fernando Nobre, Rosane Paixão Schlatter, Miguel Gus, Caroline Nespolo de David, Leticia Rafaelli, Guilhermo Prates Sesin, Otávio Berwanger, Paul K. Whelton,
Tópico(s)Nutritional Studies and Diet
ResumoTo determine the effectiveness of low-dose diuretic therapy to achieve an optimal level of blood pressure (BP) in adults with prehypertension.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 12.5 mg and amiloride 2.5 mg or placebo once a day. The main outcomes were the percentage of participants who achieved an optimal level of BP.A total of 372 participants were randomly allocated to diuretics and 358 to placebo. After 18 months of treatment, optimal BP was noted in 25.6% of the diuretic group and 19.3% in the placebo group (P < 0.05). The mean net reduction in SBP and DBP for the diuretic group compared with placebo was 2.8 mmHg (95% CI 1.1 to 4.5) and 1.1 mmHg (95% CI -0.09 to 2.4), respectively. Most participants in the active treatment group (74.5%) and in the placebo group (80.7%) continued to have BP in the prehypertension range or progressed to hypertension.Low-dose diuretic therapy increased the probability of individuals with prehypertension to achieve optimal BP but most of those treated continued to have a BP in the prehypertension range or progressed to having overt hypertension.
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