Effectiveness of low-dose diuretics for blood pressure reduction to optimal values in prehypertension: A randomizedclinical trial

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dc.contributor.authorFuchs, Flávio D.
dc.contributor.authorFuchs, Sandra C.
dc.contributor.authorPoli-de-Figueiredo, Carlos E.
dc.contributor.authorFigueiredo Neto, José A.
dc.contributor.authorScala, Luiz César N.
dc.contributor.authorVilela-Martin, José F.
dc.contributor.authorMoreira, Leila B.
dc.contributor.authorChaves, Hilton
dc.contributor.authorGomes, Marco Mota
dc.contributor.authorDe Sousa, Marcos R.
dc.contributor.authorE Silva, Ricardo Pereira
dc.contributor.authorCastro, Iran
dc.contributor.authorCesarino, Evandro José
dc.contributor.authorSousa, Ana Luiza Lima
dc.contributor.authorAlves, João Guilherme
dc.contributor.authorSteffens, André Avelino
dc.contributor.authorBrandão, Andréa Araujo
dc.contributor.authorBortolotto, Luiz Aparecido
dc.contributor.authorNeto, Abrahão Afiune
dc.contributor.authorNóbrega, Antônio C.
dc.contributor.authorFranco, Roberto Silva [UNESP]
dc.contributor.authorFilho, Dario C. Sobral
dc.contributor.authorNobre, Fernando
dc.contributor.authorSchlatter, Rosane
dc.contributor.authorGus, Miguel
dc.contributor.authorDe David, Caroline Nespolo
dc.contributor.authorRafaelli, Leticia
dc.contributor.authorSesin, Guilhermo Prates
dc.contributor.authorBerwanger, Otávio
dc.contributor.authorWhelton, Paul K.
dc.contributor.institutionUniversidade Federal do Rio Grande do Sul
dc.contributor.institutionPUCRS
dc.contributor.institutionUniversidade Federal do Maranhão
dc.contributor.institutionUniversidade Federal de Mato Grosso
dc.contributor.institutionHospital de Base
dc.contributor.institutionUniversidade Federal de Pernambuco (UFPE)
dc.contributor.institutionHospital do Coração
dc.contributor.institutionUniversidade Federal de Minas Gerais (UFMG)
dc.contributor.institutionUniversidade Federal do Ceará
dc.contributor.institutionInstituto de Cardiologia
dc.contributor.institutionUniversidade de São Paulo (USP)
dc.contributor.institutionUniversidade Federal de Goiás (UFG)
dc.contributor.institutionInstituto de Medicina Integral Prof. Fernando Figueira
dc.contributor.institutionUniversidade Federal de Pelotas
dc.contributor.institutionUniversidade do Estado do Rio de Janeiro (UERJ)
dc.contributor.institutionHospital do Coração Anis Rassi
dc.contributor.institutionUniversidade Federal Fluminense (UFF)
dc.contributor.institutionUniversidade Estadual Paulista (UNESP)
dc.contributor.institutionHospital Universitário PROCAPE
dc.contributor.institutionTulane University School of Public Health and Tropical Medicine
dc.contributor.institutionResearch Institute HC or Hospital do Coração
dc.date.accessioned2022-04-28T19:09:40Z
dc.date.available2022-04-28T19:09:40Z
dc.date.issued2018-04-01
dc.description.abstractBackground: 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 12.5mg and amiloride 2.5mg or placebo once a day. The main outcomes were the percentage of participants who achieved an optimal level of BP. Results: 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 2.8mmHg (95% CI 1.1 to 4.5) and 1.1mmHg (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. Conclusion: 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.en
dc.description.affiliationServiço de Cardiologia Hospital de Clínicas de Porto Alegre Universidade Federal do Rio Grande do Sul, Ramiro Barcelos, 2350
dc.description.affiliationFaculdade deMedicina Hospital São Lucas PUCRS
dc.description.affiliationHospital Universitário Universidade Federal do Maranhão
dc.description.affiliationHospital Universitário Júlio Müller Universidade Federal de Mato Grosso
dc.description.affiliationFaculdade de Medicina de São José do Rio Preto Hospital de Base
dc.description.affiliationUniversidade Federal de Pernambuco
dc.description.affiliationHospital do Coração
dc.description.affiliationHospital das Clínicas da Universidade Federal de Minas Gerais
dc.description.affiliationHospital Universitário Walter Cantídio Universidade Federal do Ceará
dc.description.affiliationInstituto de Cardiologia
dc.description.affiliationFaculdade de Ciências Farmacêuticas USP Ribeirão Preto
dc.description.affiliationHospital das Clínicas da Universidade Federal de Goiás
dc.description.affiliationInstituto de Medicina Integral Prof. Fernando Figueira
dc.description.affiliationUniversidade Federal de Pelotas
dc.description.affiliationUniversidade do Estado do Rio de Janeiro
dc.description.affiliationInstituto do Coração Faculdade deMedicina Universidade de São Paulo
dc.description.affiliationHospital do Coração Anis Rassi
dc.description.affiliationHospital Universitário Antônio Pedro Universidade Federal Fluminense
dc.description.affiliationFaculdade de Medicina de Botucatu
dc.description.affiliationHospital Universitário PROCAPE
dc.description.affiliationFaculdade deMedicina de Ribeirão Preto USP Ribeirão Preto
dc.description.affiliationDepartment of Epidemiology Tulane University School of Public Health and Tropical Medicine
dc.description.affiliationResearch Institute HC or Hospital do Coração
dc.description.affiliationUnespFaculdade de Medicina de Botucatu
dc.description.sponsorshipMinistry of Science and Technology
dc.format.extent933-938
dc.identifierhttp://dx.doi.org/10.1097/HJH.0000000000001624
dc.identifier.citationJournal of Hypertension, v. 36, n. 4, p. 933-938, 2018.
dc.identifier.doi10.1097/HJH.0000000000001624
dc.identifier.issn1473-5598
dc.identifier.issn0263-6352
dc.identifier.scopus2-s2.0-85049680825
dc.identifier.urihttp://hdl.handle.net/11449/221112
dc.language.isoeng
dc.relation.ispartofJournal of Hypertension
dc.sourceScopus
dc.subjectChlorthalidone and amiloride
dc.subjectClinical trials
dc.subjectHypertension
dc.subjectOptimal blood pressure
dc.subjectPrehypertension
dc.titleEffectiveness of low-dose diuretics for blood pressure reduction to optimal values in prehypertension: A randomizedclinical trialen
dc.typeArtigo

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