title: Parallel-group 8-week study on chlorthalidone effects in hypertensives with low kidney function.
abstract: 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 <60 mL/min×1.73 m(2). Screening period consisted of 2 visits for patient selection and pretreatment laboratory evaluations (baseline). Inclusion criteria were uncontrolled hypertension on nondiuretic antihypertensive treatment. Exclusion criteria were chlorthalidone contraindications, refused consent, treatment with >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 control: n=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 control: systolic 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<0.01). Data show that short-term chlorthalidone effects were not reduced in hypertensives with low kidney function.
authors.affiliation: Department of Medicine and Surgery, University of Salerno, Campus of Medicine, via Salvador Allende, 43, 84081 Baronissi, Italy. mcirillo@unisa.it.
authors.forename: Massimo
authors.initials: M
authors.lastname: Cirillo
authors.forename: Fabiana
authors.initials: F
authors.lastname: Marcarelli
authors.forename: Alessandra A
authors.initials: AA
authors.lastname: Mele
authors.forename: Massimo
authors.initials: M
authors.lastname: Romano
authors.forename: Cinzia
authors.initials: C
authors.lastname: Lombardi
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Bilancio
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000494:pharmacology* / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D002752:Chlorthalidone / Q000494:pharmacology* / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology*; D007668:Kidney / Q000187:drug effects* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011188:Potassium / Q000097:blood; D011446:Prospective Studies; D016037:Single-Blind Method; D016896:Treatment Outcome; D014527:Uric Acid / Q000097:blood
chemical_list: D000959:Antihypertensive Agents; D014527:Uric Acid; D002752:Chlorthalidone; D011188:Potassium
keywords: chlorthalidone; clinical trial; creatinine; glomerular filtration rate; hypertension; kidney