Artículos de revistas
Effectiveness of low-dose diuretics for blood pressure reduction to optimal values in prehypertension: A randomizedclinical trial
Fecha
2018-04-01Registro en:
Journal of Hypertension, v. 36, n. 4, p. 933-938, 2018.
1473-5598
0263-6352
10.1097/HJH.0000000000001624
2-s2.0-85049680825
Autor
Universidade Federal do Rio Grande do Sul
PUCRS
Universidade Federal do Maranhão
Universidade Federal de Mato Grosso
Hospital de Base
Universidade Federal de Pernambuco (UFPE)
Hospital do Coração
Universidade Federal de Minas Gerais (UFMG)
Universidade Federal do Ceará
Instituto de Cardiologia
Universidade de São Paulo (USP)
Universidade Federal de Goiás (UFG)
Instituto de Medicina Integral Prof. Fernando Figueira
Universidade Federal de Pelotas
Universidade do Estado do Rio de Janeiro (UERJ)
Hospital do Coração Anis Rassi
Universidade Federal Fluminense (UFF)
Universidade Estadual Paulista (UNESP)
Hospital Universitário PROCAPE
Tulane University School of Public Health and Tropical Medicine
Research Institute HC or Hospital do Coração
Institución
Resumen
Background: 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.