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March 1, 1986Journal of the American Geriatrics Society

Isolated Systolic Hypertension in the Elderly: A Placebo‐Controlled, Dose‐Response Evaluation of Chlorthalidone

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Why the study?

Does chlorthalidone improve therapeutic success and reduce blood pressure safely in patients 60 years of age or older with isolated systolic hypertension?

Population

171 patients, 60 years of age or older with isolated systolic hypertension

Comparison

Chlorthalidone 12.5, 25.0, or 50.0 mg once daily… vs Placebo once daily for 12 weeks

Design

RCT, randomly assigned, placebo-controlled

Follow-up

12 weeks

Authors

JMJohn H. MorledgeUniversity of Wisconsin–MadisonBEBruce EttingerKaiser PermanenteJAJuan ArandaUniversidad Complutense de Madrid

Discussion

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Implication

Low-dose chlorthalidone safely controls isolated systolic hypertension in older adults; confirms optimal dosing with minimal side effects versus higher doses.

Key Points

  • Evaluate the dose-response efficacy and safety profile of various chlorthalidone doses in elderly patients with isolated systolic hypertension.
  • Randomized, placebo-controlled trial enrolling 171 patients aged 60 years or older with isolated systolic hypertension.
  • Participants were randomly assigned to receive chlorthalidone (12.5 mg, 25.0 mg, or 50.0 mg) or placebo once daily for 12 weeks.
  • The majority of patients receiving chlorthalidone 12.5 mg achieved therapeutic success without clinically significant biochemical changes or side effects.
  • The 50.0 mg dose provided minimal additional efficacy compared with the 25.0 mg dose while causing significantly higher rates of drug-related side effects than placebo.

Structured PICO

Does chlorthalidone improve therapeutic success and reduce blood pressure safely in patients 60 years of age or older with isolated systolic hypertension?

P
Population
171 patients, 60 years of age or older with isolated systolic hypertension
I
Intervention
Chlorthalidone 12.5, 25.0, or 50.0 mg once daily for 12 weeks
C
Comparator
Placebo once daily for 12 weeks
O
Outcome
Therapeutic success at 12 weekssurrogate

Low-dose chlorthalidone (12.5 mg/day) provides effective and safe treatment for isolated systolic hypertension in the elderly, avoiding the increased side effects seen at higher doses.

Cite This Study

Morledge et al. (1986) studied this question.

synapsesocial.com/papers/6a129c75ea48cb855a352d07https://doi.org/10.1111/j.1532-5415.1986.tb04203.x

Topics

Hypertension management
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Dose response to chlorthalidone in patients with mild hypertension; Efficacy of a lower dose1978 · 108 citations
  2. 2Effects of treatment on morbidity in hypertension. Results in patients with diastolic blood pressures averaging 115 through 129 mm Hg1967 · 1,301 citations
  3. 3Controlled trial of biofeedback-aided behavioural methods in reducing mild hypertension.1981 · 153 citations
  4. 4Behavioral Treatment of High Blood Pressure: III. Follow-Up Results and Treatment Recommendations1983 · 62 citations
  5. 5The 1984 Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure1984 · 594 citations