What is the clinical evidence from this study?

Study design: Other. Population: Essential hypertension (n=10). Intervention: Hydrochlorothiazide vs. Placebo. Primary outcome: Renal haemodynamics (renal blood flow, glomerular filtration rate, renal vascular resistance and filtration fraction) (p=<0.01).

What question did this study set out to answer?

To evaluate the immediate and extended effects of hydrochlorothiazide on renal hemodynamics, renin levels, and sympathetic activity in patients with essential hypertension.

May 1, 1979Clinical Science

Long-Term versus Short-Term Effects of Hydrochlorothiazide on Renal Haemodynamics in Essential Hypertension

Q: What are the key findings of this study?

Hydrochlorothiazide treatment in essential hypertension initially decreased renal blood flow (P<0.01), followed by a progressive rise above placebo levels at 9 months.

Q: What question did this study set out to answer?

To evaluate the immediate and extended effects of hydrochlorothiazide on renal hemodynamics, renin levels, and sympathetic activity in patients with essential hypertension.

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Key result

Hydrochlorothiazide treatment in essential hypertension initially decreased renal blood flow (P<0.01), followed by a progressive rise above placebo levels at 9 months.

Why the study?

Does hydrochlorothiazide improve renal hemodynamics over the long term in patients with essential hypertension?

Population

10 patients with essential hypertension

Comparison

Hydrochlorothiazide evaluated at 1 week, 3, 6… vs Placebo (baseline/control period)

Design

Cohort

Follow-up

9 months

Authors

PBP. van BrummelenLeiden University MWM. WoerleeUtrecht University MSMaarten A.D.H. SchalekampGeneral / Preventive / Lipids

Discussion

Member takes

Implication

May support long-term renal hemodynamic recovery with hydrochlorothiazide; hypothesis-generating and requires randomized confirmation before practice change.

Key Points

To evaluate the immediate and extended effects of hydrochlorothiazide on renal hemodynamics, renin levels, and sympathetic activity in patients with essential hypertension.
Assessed 10 patients with essential hypertension during placebo baseline and after 1 week, 3 months, 6 months, and 9 months of hydrochlorothiazide therapy.
Measured renal blood flow, glomerular filtration rate, renal vascular resistance, filtration fraction, plasma renin concentration, and urinary vanillylmandelic acid excretion.
Mean arterial pressure decreased significantly throughout treatment, with renal blood flow dropping at 1 week (P < 0.01) before rising above placebo baseline in 8 of 10 patients by 9 months.
Renal vascular resistance and filtration fraction increased at week 1 but subsequently declined, with vascular resistance remaining significantly below placebo values at 3, 6, and 9 months.
Plasma renin concentration remained elevated across 9 months, whereas urinary vanillylmandelic acid fell below baseline amounts after an initial rise (P < 0.05).

Structured PICO

Does hydrochlorothiazide improve renal hemodynamics over the long term in patients with essential hypertension?

Population

10 patients with essential hypertension evaluated during placebo and up to 9 months of hydrochlorothiazide therapy.

Intervention

Hydrochlorothiazide evaluated at 1 week, 3, 6, and 9 months

Comparator

Placebo (baseline/control period)

Outcome

Renal hemodynamics (renal blood flow, glomerular filtration rate, renal vascular resistance, and filtration fraction)surrogate

Main Result

p-value: p=<0.01

Long-term treatment with hydrochlorothiazide has a favorable effect on abnormal renal hemodynamics in essential hypertension, contrasting with initial short-term reductions in renal blood flow.

Cite This Study

Brummelen et al. (1979) studied Essential hypertension (n=10). Hydrochlorothiazide vs. Placebo was evaluated on Renal haemodynamics (renal blood flow, glomerular filtration rate, renal vascular resistance and filtration fraction) (p=<0.01). Hydrochlorothiazide treatment in essential hypertension initially decreased renal blood flow (P<0.01), followed by a progressive rise above placebo levels at 9 months.

synapsesocial.com/papers/6a9a4fc34e49e699219e6e2f https://doi.org/10.1042/cs0560463

Topics

Hypertension management

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May 1, 1979Clinical Science

Long-Term versus Short-Term Effects of Hydrochlorothiazide on Renal Haemodynamics in Essential Hypertension

View Full Paper

Ask AI

Bookmark

Key result

Hydrochlorothiazide treatment in essential hypertension initially decreased renal blood flow (P<0.01), followed by a progressive rise above placebo levels at 9 months.

Why the study?

Does hydrochlorothiazide improve renal hemodynamics over the long term in patients with essential hypertension?

Population

10 patients with essential hypertension

Comparison

Hydrochlorothiazide evaluated at 1 week, 3, 6… vs Placebo (baseline/control period)

Design

Cohort

Follow-up

9 months

Authors

PBP. van BrummelenLeiden University MWM. WoerleeUtrecht University MSMaarten A.D.H. SchalekampGeneral / Preventive / Lipids

Discussion

Member takes

Implication

May support long-term renal hemodynamic recovery with hydrochlorothiazide; hypothesis-generating and requires randomized confirmation before practice change.

Key Points

To evaluate the immediate and extended effects of hydrochlorothiazide on renal hemodynamics, renin levels, and sympathetic activity in patients with essential hypertension.
Assessed 10 patients with essential hypertension during placebo baseline and after 1 week, 3 months, 6 months, and 9 months of hydrochlorothiazide therapy.
Measured renal blood flow, glomerular filtration rate, renal vascular resistance, filtration fraction, plasma renin concentration, and urinary vanillylmandelic acid excretion.
Mean arterial pressure decreased significantly throughout treatment, with renal blood flow dropping at 1 week (P < 0.01) before rising above placebo baseline in 8 of 10 patients by 9 months.
Renal vascular resistance and filtration fraction increased at week 1 but subsequently declined, with vascular resistance remaining significantly below placebo values at 3, 6, and 9 months.
Plasma renin concentration remained elevated across 9 months, whereas urinary vanillylmandelic acid fell below baseline amounts after an initial rise (P < 0.05).

Structured PICO

Does hydrochlorothiazide improve renal hemodynamics over the long term in patients with essential hypertension?

Population

10 patients with essential hypertension evaluated during placebo and up to 9 months of hydrochlorothiazide therapy.

Intervention

Hydrochlorothiazide evaluated at 1 week, 3, 6, and 9 months

Comparator

Placebo (baseline/control period)

Outcome

Renal hemodynamics (renal blood flow, glomerular filtration rate, renal vascular resistance, and filtration fraction)surrogate

Main Result

p-value: p=<0.01

Long-term treatment with hydrochlorothiazide has a favorable effect on abnormal renal hemodynamics in essential hypertension, contrasting with initial short-term reductions in renal blood flow.

Cite This Study

synapsesocial.com/papers/6a9a4fc34e49e699219e6e2f https://doi.org/10.1042/cs0560463

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