Key result
Diuretic-based treatment with chlorthalidone reduced the risk of cardiovascular events in older patients with isolated systolic hypertension across four mild renal dysfunction subgroups (RR 0.59 to 0.73).
Why the study?
Does diuretic-based treatment reduce cardiovascular events in older patients with isolated systolic hypertension and mild renal dysfunction?
Population
4336 persons aged 60 years and older with isolated systolic hypertension and mild renal dysfunction.
Comparison
Chlorthalidone, with the addition of atenolol or… vs Placebo
Design
RCT, randomly assigned
Follow-up
5 years
Authors
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Diuretic-based therapy may lower CV events in elderly ISH patients with mild renal dysfunction; leaves open need for dedicated RCTs before practice change.
RCT (n=4,336)
randomly assigned
Does diuretic-based treatment reduce cardiovascular events in older patients with isolated systolic hypertension and mild renal dysfunction?
Effect estimate: RR 0.73 to 0.59 across 4 creatinine subgroups
Diuretic-based treatment with chlorthalidone effectively prevents cardiovascular events in older patients with isolated systolic hypertension, including those with mild renal dysfunction.
Pahor et al. (1998) conducted an RCT in Isolated systolic hypertension and renal dysfunction (n=4,336). Chlorthalidone (with atenolol or reserpine if needed) vs. Placebo was evaluated on First-occurring cardiovascular events (including stroke, TIA, MI, heart failure, CABG, angioplasty, aneurysm, endarterectomy, sudden death, or rapid death) (RR 0.73 to 0.59 across 4 creatinine subgroups). Diuretic-based treatment with chlorthalidone reduced the risk of cardiovascular events in older patients with isolated systolic hypertension across four mild renal dysfunction subgroups (RR 0.59 to 0.73).
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