Parallel-Group 8-Week Study on Chlorthalidone Effects in Hypertensives With Low Kidney Function

• Published in: Hypertension (Dallas, Tex. 1979) Tex. 1979), 2014-04, Vol.63 (4), p.692-697
• Main Authors: Cirillo, Massimo, Marcarelli, Fabiana, Mele, Alessandra A, Romano, Massimo, Lombardi, Cinzia, Bilancio, Giancarlo
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antihypertensive Agents - pharmacology; Antihypertensive Agents - therapeutic use; Arterial hypertension. Arterial hypotension; Biological and medical sciences; Blood and lymphatic vessels; Blood Pressure - drug effects; Blood Pressure - physiology; Cardiology. Vascular system; Chlorthalidone - pharmacology; Chlorthalidone - therapeutic use; Dose-Response Relationship, Drug; Drug Therapy, Combination; Female; Glomerular Filtration Rate - drug effects; Glomerular Filtration Rate - physiology; Humans; Hypertension - drug therapy; Hypertension - physiopathology; Kidney - drug effects; Kidney - physiopathology; Male; Medical sciences; Middle Aged; Potassium - blood; Prospective Studies; Single-Blind Method; Treatment Outcome; Uric Acid - blood
• ISSN: 0194-911X; 1524-4563
• DOI: 10.1161/HYPERTENSIONAHA.113.02793

Short-term effects of chlorthalidone are unknown in low kidney function. The effects of 8-week treatment with 25-mg chlorthalidone on the top of ongoing treatment were compared between control hypertensives and low kidney function hypertensives as assessed by estimated glomerular filtration rate 3 antihypertensive drugs, severe hypertension, severe comorbidities, unreliable estimated glomerular filtration rate. Treatment period consisted of 5 visits (weeks 1, 2, 4, 6, and 8). Post-treatment laboratory evaluations were performed 3 to 4 days before week-8 visit. The 2 groups differed for baseline estimated glomerular filtration rate (low kidney function and controln=60 and 60; mean, 39 and 76; range, 15–59 and 60–104) but not for sex, age, and baseline blood pressure. Week-8 blood pressure changes were a decrease in both groups (low kidney function and controlsystolic pressure, −20 and −23; 95% confidence interval, −22/−18 and −26/−19; diastolic pressure, −9 and −10, −11/−7, and −13/−8) without significant between-group differences. Incidence of adverse events was similar in the 2 groups (15.0% and 16.7%). Baseline estimated glomerular filtration rate did not predict blood pressure changes and adverse events in either groups (P>0.6). In both groups, post-treatment changes were a decrease for estimated glomerular filtration rate and serum potassium, an increase for serum uric acid (P