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Effectiveness of chlorthalidone plus amiloride for the prevention of hypertension the PREVER-Prevention Randomized Clinical Trial

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Effectiveness of chlorthalidone plus amiloride for the prevention of hypertension the PREVER-Prevention Randomized Clinical Trial

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Título Effectiveness of chlorthalidone plus amiloride for the prevention of hypertension the PREVER-Prevention Randomized Clinical Trial
Autor Fuchs, Sandra Cristina Pereira Costa
Figueiredo, Carlos Eduardo Poli de
Figueiredo Neto, José Albuquerque de
Scala, Luiz César Nazário
Whelton, Paul Kieran
Mosele, Francisca
Mello, Renato Gorga Bandeira de
Martin, Jose Fernando Vilela
Moreira, Leila Beltrami
Chaves, Hilton
Gomes, Marco Mota
Sousa, Marcos Roberto de
Silva, Ricardo Pereira e
Castro, Iran
Cesarino, Evandro José
Jardim, Paulo Cesar Brandao Veiga
Alves, João Guilherme Bezerra
Steffens, André Avelino
Brandão, Andréa Araujo
Consolim-Colombo, Fernanda Marciano
Alencastro, Paulo Ricardo de
Afiune Neto, Abrahão
Nobrega, Antonio Claudio Lucas da
Franco, Roberto Silva
Sobral Filho, Dário Celestino
Bordignon, Alexandro
Nobre, Fernando
Schlatter, Rosane Paixão
Gus, Miguel
Fuchs, Felipe Costa
Berwanger, Otávio
Fuchs, Flávio Danni
Abstract Background-—Prehypertension is associated with higher cardiovascular risk, target organ damage, and incidence of hypertension. The Prevention of Hypertension in Patients with PreHypertension (PREVER-Prevention) trial aimed to evaluate the efficacy and safety of a low-dose diuretic for the prevention of hypertension and end-organ damage. Methods and Results-—This randomized, parallel, double-blind, placebo-controlled trialwas conducted in 21 Brazilian academicmedical centers. Participants with prehypertensionwho were aged 30 to70 years andwho did not reach optimal blood pressure after 3 months of lifestyle intervention were randomized to a chlorthalidone/amiloride combination pill or placebo and were evaluated every 3 months during 18 months of treatment. The primary outcome was incidence of hypertension. Development or worsening of microalbuminuria, new-onset diabetes mellitus, and reduction of left ventricular mass were secondary outcomes. Participant characteristics were evenly distributed by trial arms The incidence of hypertension was significantly lower in 372 study participants allocated to diuretics compared with358 allocated to placebo (hazard ratio 0.56, 95%CI 0.38–0.82), resulting in a cumulative incidence of11.7% in the diuretic arm versus 19.5% in the placebo arm(P=0.004). Adverse events; levels of blood glucose, glycosylated hemoglobin, creatinine, and microalbuminuria; and incidence of diabetes mellitus were no different between the 2 arms. Left ventricular mass assessed through Sokolow-Lyon voltage and voltage-duration product decreased to a greater extent in participants allocated to diuretic therapy compared with placebo (P=0.02). Conclusions-—A combination of low-dose chlorthalidone and amiloride effectively reduces the risk of incident hypertension and beneficially affects left ventricular mass in patients with prehypertension.
Contido em Journal of the American Heart Association. Oxford. Vol. 5, no. 12 (Dec. 2016), e004248, 16 p.
Assunto Clortalidona
Diuréticos
Doenças cardiovasculares
Hipertensão
Pressão sanguínea
[en] Amiloride
[en] Blood pressure
[en] Cardiovascular diseases
[en] Chlorthalidone
[en] Clinical trials
[en] Diuretics
[en] Hypertension
[en] Left ventricular mass
[en] Microalbuminuria
[en] Potassium-sparing antihypertensive agents
[en] Prehypertension
[en] Prevention
Origem Estrangeiro
Tipo Artigo de periódico
URI http://hdl.handle.net/10183/169192
Arquivos Descrição Formato
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