What is the clinical evidence from this study?

Study design: RCT. Population: Mild to moderate hypertension (n=111). Intervention: Hydrochlorothiazide vs. Placebo. Primary outcome: Blood pressure and biochemical variables.

What does this research mean for the field?

Hydrochlorothiazide at a dose of 25 mg provides a definite antihypertensive effect and induces biochemical changes, whereas lower doses of 3 and 6 mg have no significant effect on blood pressure or metabolic parameters. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To characterize the lower end of the hydrochlorothiazide dose-response curve regarding antihypertensive efficacy and adverse metabolic effects in mild to moderate hypertension.

January 1, 1994Blood Pressure

Relation Between Low Dose of Hydrochlorothiazide, Antihypertensive Effect and Adverse Effects

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Key result

Hydrochlorothiazide at 25 mg demonstrated a definite antihypertensive effect and biochemical changes, whereas doses of 3 and 6 mg had no effect on blood pressure or metabolic parameters.

Why the study?

Does low-dose hydrochlorothiazide reduce blood pressure without adverse metabolic effects in patients with mild to moderate hypertension?

Population

111 patients with newly diagnosed or previously treated mild to moderate hypertension

Comparison

Hydrochlorothiazide at various doses for 6 weeks vs Placebo for 6 weeks

Design

RCT, randomly allocated, double-blind

Follow-up

6 weeks

Authors

AJA. J. JounelaUniversity of Helsinki MLMauno LiljaUniversity of Oulu JLJarmo LummeOulu University Hospital

Discussion

Member takes

Implication

Low-dose hydrochlorothiazide lacks antihypertensive efficacy; challenges separability of dose-response curves for blood pressure reduction versus metabolic effects.

Key Points

To characterize the lower end of the hydrochlorothiazide dose-response curve regarding antihypertensive efficacy and adverse metabolic effects in mild to moderate hypertension.
Conducted a multicentre, double-blind, parallel-group trial in Scandinavia involving N=111 patients with newly diagnosed or previously treated mild to moderate hypertension (untreated diastolic blood pressure of 95–115 mmHg after a 4-week placebo period).
Randomly allocated patients to receive hydrochlorothiazide (3 mg, 6 mg, 12.5 mg, or 25 mg) or placebo daily for 6 weeks.
Measured blood pressure alongside biochemical parameters, including plasma renin activity, serum potassium, magnesium, urate, fasting glucose, lipids, and apolipoproteins.
Hydrochlorothiazide at 25 mg demonstrated a definite antihypertensive effect, whereas 12.5 mg produced only a borderline reduction in blood pressure.
Doses of 3 mg and 6 mg showed no detectable effect on blood pressure or biochemical variables.
Biochemical changes, including shifts in plasma renin activity, serum potassium, and serum urate, were observed following the 12.5 mg and 25 mg doses.

Study Design

Type

RCT (n=111)

Blinding

Double-blind

Randomization

Randomly allocated

Multicenter

Yes

Structured PICO

Does low-dose hydrochlorothiazide reduce blood pressure without adverse metabolic effects in patients with mild to moderate hypertension?

Population

111 patients with newly diagnosed or previously treated mild to moderate hypertension (untreated diastolic blood pressure of 95-115 mmHg after 4 weeks placebo)

Intervention

Hydrochlorothiazide at various doses (3, 6, 12.5, or 25 mg) for 6 weeks

Comparator

Placebo for 6 weeks

Outcome

Blood pressuresurrogate

Hydrochlorothiazide at 25 mg provides definite antihypertensive effects but causes metabolic changes, while doses of 3 and 6 mg are ineffective for blood pressure reduction.

Cite This Study

Jounela et al. (1994) conducted an RCT in Mild to moderate hypertension (n=111). Hydrochlorothiazide vs. Placebo was evaluated on Blood pressure and biochemical variables. Hydrochlorothiazide at 25 mg demonstrated a definite antihypertensive effect and biochemical changes, whereas doses of 3 and 6 mg had no effect on blood pressure or metabolic parameters.

synapsesocial.com/papers/6a129c75ea48cb855a352cfa https://doi.org/10.3109/08037059409102262

Topics

Hypertension management

View Full Paper

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January 1, 1994Blood Pressure

Relation Between Low Dose of Hydrochlorothiazide, Antihypertensive Effect and Adverse Effects

View Full Paper

Ask AI

Bookmark

Key result

Hydrochlorothiazide at 25 mg demonstrated a definite antihypertensive effect and biochemical changes, whereas doses of 3 and 6 mg had no effect on blood pressure or metabolic parameters.

Why the study?

Does low-dose hydrochlorothiazide reduce blood pressure without adverse metabolic effects in patients with mild to moderate hypertension?

Population

111 patients with newly diagnosed or previously treated mild to moderate hypertension

Comparison

Hydrochlorothiazide at various doses for 6 weeks vs Placebo for 6 weeks

Design

RCT, randomly allocated, double-blind

Follow-up

6 weeks

Authors

AJA. J. JounelaUniversity of Helsinki MLMauno LiljaUniversity of Oulu JLJarmo LummeOulu University Hospital

Discussion

Member takes

Implication

Low-dose hydrochlorothiazide lacks antihypertensive efficacy; challenges separability of dose-response curves for blood pressure reduction versus metabolic effects.

Key Points

To characterize the lower end of the hydrochlorothiazide dose-response curve regarding antihypertensive efficacy and adverse metabolic effects in mild to moderate hypertension.
Conducted a multicentre, double-blind, parallel-group trial in Scandinavia involving N=111 patients with newly diagnosed or previously treated mild to moderate hypertension (untreated diastolic blood pressure of 95–115 mmHg after a 4-week placebo period).
Randomly allocated patients to receive hydrochlorothiazide (3 mg, 6 mg, 12.5 mg, or 25 mg) or placebo daily for 6 weeks.
Measured blood pressure alongside biochemical parameters, including plasma renin activity, serum potassium, magnesium, urate, fasting glucose, lipids, and apolipoproteins.
Hydrochlorothiazide at 25 mg demonstrated a definite antihypertensive effect, whereas 12.5 mg produced only a borderline reduction in blood pressure.
Doses of 3 mg and 6 mg showed no detectable effect on blood pressure or biochemical variables.
Biochemical changes, including shifts in plasma renin activity, serum potassium, and serum urate, were observed following the 12.5 mg and 25 mg doses.

Study Design

Type

RCT (n=111)

Blinding

Double-blind

Randomization

Randomly allocated

Multicenter

Yes

Structured PICO

Does low-dose hydrochlorothiazide reduce blood pressure without adverse metabolic effects in patients with mild to moderate hypertension?

Population

111 patients with newly diagnosed or previously treated mild to moderate hypertension (untreated diastolic blood pressure of 95-115 mmHg after 4 weeks placebo)

Intervention

Hydrochlorothiazide at various doses (3, 6, 12.5, or 25 mg) for 6 weeks

Comparator

Placebo for 6 weeks

Outcome

Blood pressuresurrogate

Hydrochlorothiazide at 25 mg provides definite antihypertensive effects but causes metabolic changes, while doses of 3 and 6 mg are ineffective for blood pressure reduction.

Cite This Study

synapsesocial.com/papers/6a129c75ea48cb855a352cfa https://doi.org/10.3109/08037059409102262

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