Effectiveness of chlorthalidone/amiloride versus losartan in patients with stage I hypertension and diabetes mellitus: results from the PREVER-treatment randomized controlled trial

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dc.contributor.authorFuchs, Flávio D.
dc.contributor.authorScala, Luiz C. N.
dc.contributor.authorVilela-Martin, José F.
dc.contributor.authorWhelton, Paul K.
dc.contributor.authorPoli-de-Figueiredo, Carlos E.
dc.contributor.authorPereira E Silva, Ricardo
dc.contributor.authorGus, Miguel
dc.contributor.authorBortolotto, Luiz A.
dc.contributor.authorConsolim-Colombo, Fernanda M.
dc.contributor.authorSchlatter, Rosane P.
dc.contributor.authorCesarino, José E.
dc.contributor.authorCastro, Iran
dc.contributor.authorFigueiredo Neto, José A.
dc.contributor.authorChaves, Hilton
dc.contributor.authorSteffens, André A.
dc.contributor.authorAlves, João G.
dc.contributor.authorBrandão, Andréa A.
dc.contributor.authorde Sousa, Marcos R.
dc.contributor.authorJardim, Paulo C.
dc.contributor.authorMoreira, Leila B.
dc.contributor.authorFranco, Roberto S. [UNESP]
dc.contributor.authorGomes, Marco M.
dc.contributor.authorAfiune Neto, Abrahão
dc.contributor.authorFuchs, Felipe C.
dc.contributor.authorSobral Filho, Dario C.
dc.contributor.authorNóbrega, Antônio C.
dc.contributor.authorNobre, Fernando
dc.contributor.authorBerwanger, Otávio
dc.contributor.authorFuchs, Sandra C.
dc.contributor.institutionINCT PREVER
dc.contributor.institutionUniversidade Federal de Mato Grosso
dc.contributor.institutionFaculdade de Medicina São José Do Rio Preto
dc.contributor.institutionTulane University
dc.contributor.institutionPUCRS
dc.contributor.institutionUniversidade Federal do Ceará
dc.contributor.institutionUniversidade de São Paulo (USP)
dc.contributor.institutionUniversidade Federal do Rio Grande Do Sul
dc.contributor.institutionInstituto de Cardiologia
dc.contributor.institutionHospital Universitário Universidade Federal do Maranhão
dc.contributor.institutionUniversidade Federal de Pernambuco (UFPE)
dc.contributor.institutionUniversidade Federal de Pelotas
dc.contributor.institutionInstituto de Medicina Integral Prof Fernando Figueira
dc.contributor.institutionUniversidade do Estado do Rio de Janeiro (UERJ)
dc.contributor.institutionUniversidade Federal de Minas Gerais (UFMG)
dc.contributor.institutionUniversidade Federal de Goiás (UFG)
dc.contributor.institutionUniversidade Estadual Paulista (UNESP)
dc.contributor.institutionHospital do Coração de Alagoas
dc.contributor.institutionAnis Rassi Hospital
dc.contributor.institutionHospital Universitário Procape
dc.contributor.institutionUFF
dc.contributor.institutionHospital Israelita Albert Einstein
dc.date.accessioned2022-04-28T19:29:26Z
dc.date.available2022-04-28T19:29:26Z
dc.date.issued2021-02-01
dc.description.abstractAims: To 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. Methods: 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. Results: 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. Conclusions: 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. Trial registration: Clinical trials registration number: NCT00971165en
dc.description.affiliationDivision of Cardiology Hospital de Clínicas de Porto Alegre Universidade Federal do Rio Grande Do Sul INCT PREVER, CPC, 5º. and Ramiro Barcelos, 2350
dc.description.affiliationHospital Universitário Júlio Müller Universidade Federal de Mato Grosso
dc.description.affiliationFaculdade de Medicina São José Do Rio Preto
dc.description.affiliationDepartment of Epidemiology School of Public Health and Tropical Medicine Tulane University
dc.description.affiliationFaculdade de Medicina Hospital São Lucas PUCRS
dc.description.affiliationHospital Universitário Walter Cantídio Universidade Federal do Ceará
dc.description.affiliationFaculdade de Medicina Instituto do Coração Universidade de São Paulo
dc.description.affiliationHospital de Clínicas de Porto Alegre Universidade Federal do Rio Grande Do Sul
dc.description.affiliationFaculdade de Ciências Farmacêuticas USP Ribeirão Preto
dc.description.affiliationInstituto de Cardiologia, Av. Princesa Isabel
dc.description.affiliationHospital Universitário Universidade Federal do Maranhão
dc.description.affiliationUniversidade Federal de Pernambuco
dc.description.affiliationUniversidade Federal de Pelotas
dc.description.affiliationInstituto de Medicina Integral Prof Fernando Figueira
dc.description.affiliationUniversidade Do Estado do Rio de Janeiro
dc.description.affiliationHospital das Clínicas da Universidade Federal de Minas Gerais
dc.description.affiliationHospital das Clínicas de Goiânia Universidade Federal de Goiás
dc.description.affiliationFaculdade de Medicina de Botucatu
dc.description.affiliationHospital do Coração de Alagoas
dc.description.affiliationAnis Rassi Hospital
dc.description.affiliationHospital Universitário Procape
dc.description.affiliationHospital Universitário Antônio Pedro UFF
dc.description.affiliationFaculdade de Medicina de Ribeirão Preto USP Ribeirão Preto
dc.description.affiliationInstituto de Pesquisa Hospital Israelita Albert Einstein
dc.description.affiliationUnespFaculdade de Medicina de Botucatu
dc.description.sponsorshipHospital de Clínicas de Porto Alegre
dc.description.sponsorshipIdHospital de Clínicas de Porto Alegre: GPPG: 08-621
dc.format.extent215-220
dc.identifierhttp://dx.doi.org/10.1007/s00592-020-01611-8
dc.identifier.citationActa Diabetologica, v. 58, n. 2, p. 215-220, 2021.
dc.identifier.doi10.1007/s00592-020-01611-8
dc.identifier.issn1432-5233
dc.identifier.issn0940-5429
dc.identifier.scopus2-s2.0-85092361547
dc.identifier.urihttp://hdl.handle.net/11449/221581
dc.language.isoeng
dc.relation.ispartofActa Diabetologica
dc.sourceScopus
dc.subjectAmiloride
dc.subjectChlorthalidone
dc.subjectDiabetes
dc.subjectDrug treatment
dc.subjectHypertension
dc.subjectLosartan
dc.titleEffectiveness of chlorthalidone/amiloride versus losartan in patients with stage I hypertension and diabetes mellitus: results from the PREVER-treatment randomized controlled trialen
dc.typeArtigo
unesp.author.orcid0000-0001-6351-9588[29]

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