Produção Nacional
Revisado por pares
Effectiveness of chlorthalidone/amiloride versus losartan in patients with stage I hypertension and diabetes mellitus: results from the PREVER-treatment randomized controlled trial
2020; Springer Science+Business Media; Volume: 58; Issue: 2 Linguagem: Inglês
10.1007/s00592-020-01611-8
ISSN1432-5233
AutoresFlávio Danni Fuchs, Luiz César Nazário Scala, José Fernando Vilela-Martin, Paul K. Whelton, Carlos Eduardo Poli‐de‐Figueiredo, Ricardo Pereira e Silva, Miguel Gus, Luiz Aparecido Bortolotto, Fernanda Marciano Consolim‐Colombo, Rosane Paixão Schlatter, Evandro José Cesarino, Iran Castro, José Albuquerque de Figueiredo Neto, Hilton Chaves, André Avelino Steffens, João Guilherme Bezerra Alves, Andréa Araújo Brandão, Marcos Roberto de Sousa, Paulo César Brandão Veiga Jardim, Leila Beltrami Moreira, Roberto Silva Franco, Marco M. Gomes, Abrahão Afiune Neto, Felipe Costa Fuchs, Dário Celestino Sobral Filho, Antônio Cláudio Lucas da Nóbrega, Fernando Nobre, Otávio Berwanger, Sandra Cristina Pereira Costa Fuchs,
Tópico(s)Nutritional Studies and Diet
ResumoTo compare the blood pressure (BP)-lowering efficacy of a chlorthalidone/amiloride combination pill with losartan, during initial management of JNC 7 Stage I hypertension in patients with type 2 diabetes mellitus.In an a priori subgroup analysis of a randomized, double-blind, controlled trial, volunteers aged 30-70 years, with stage I hypertension and diabetes mellitus, were randomized to 12.5/2.5 mg of chlorthalidone/amiloride (N = 47) or 50 mg of losartan (N = 50), and followed for 18 months in 21 clinical centers. If BP remained uncontrolled after three months, study medication dose was doubled, and if uncontrolled after six months, amlodipine (5 and 10 mg) and propranolol (40 and 80 mg BID) were added as open label drugs in a progressive fashion.Systolic BP decreased to a greater extent in participants allocated to diuretics compared to losartan (P < 0.001). After 18 months of follow-up, systolic BP was 128.4 ± 10.3 mmHg in the diuretic group versus 133.5 ± 8.0 in the losartan group (P < 0.01). In the diuretic group, 36 out of 43 participants (83.7%) had a JNC 7 normal BP, compared to 31/47 (66%) in the losartan group (P = 0.089). Serum cholesterol was higher in the diuretic arm at the end of the trial. Other biochemical parameters and reports of adverse events did not differ by treatment.Treatment of hypertension based on a combination of chlorthalidone and amiloride is more effective for BP lowering compared to losartan in patients with diabetes mellitus and hypertension.Clinical trials registration number: NCT00971165.
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