| Long-term effects of chlorthalidone versus hydrochlorothiazide on electrocardiographic left ventricular hypertrophy in the multiple risk factor intervention trial. | |
| | |
MedLine Citation:
|
PMID: 22025372 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Chlorthalidone (CTD) reduces 24-hour blood pressure more effectively than hydrochlorothiazide (HCTZ), but whether this influences electrocardiographic left ventricular hypertrophy is uncertain. One source of comparative data is the Multiple Risk Factor Intervention Trial, which randomly assigned 8012 hypertensive men to special intervention (SI) or usual care. SI participants could use CTD or HCTZ initially; previous analyses have grouped clinics by their main diuretic used (C-clinics: CTD; H-clinics: HCTZ). After 48 months, SI participants receiving HCTZ were recommended to switch to CTD, in part because higher mortality was observed for SI compared with usual care participants in H-clinics, whereas the opposite was found in C-clinics. In this analysis, we examined change in continuous measures of electrocardiographic left ventricular hypertrophy using both an ecological analysis by previously reported C- or H-clinic groupings and an individual participant analysis where use of CTD or HCTZ by SI participants was considered and updated annually. Through 48 months, differences between SI and usual care in left ventricular hypertrophy were larger for C-clinics compared with H-clinics (Sokolow-Lyon: -93.9 versus -54.9 μV, P=0.049; Cornell voltage: -68.1 versus -35.9 μV, P=0.019; Cornell voltage product: -4.6 versus -2.2 μV/ms, P=0.071; left ventricular mass: -4.4 versus -2.8 g, P=0.002). At the individual participant level, Sokolow-Lyon and left ventricular mass were significantly lower for SI men receiving CTD compared with HCTZ through 48 months and 84 months of follow-up. Our findings on left ventricular hypertrophy support the idea that greater blood pressure reduction with CTD than HCTZ may have led to differences in mortality observed in the Multiple Risk Factor Intervention Trial. |
| | |
Authors:
|
Michael E Ernst; James D Neaton; Richard H Grimm; Gary Collins; William Thomas; Elsayed Z Soliman; Ronald J Prineas; |
Publication Detail:
|
Type: Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural Date: 2011-10-24 |
Journal Detail:
|
Title: Hypertension Volume: 58 ISSN: 1524-4563 ISO Abbreviation: Hypertension Publication Date: 2011 Dec |
Date Detail:
|
Created Date: 2011-11-18 Completed Date: 2012-01-03 Revised Date: 2013-02-19 |
Medline Journal Info:
|
Nlm Unique ID: 7906255 Medline TA: Hypertension Country: United States |
Other Details:
|
Languages: eng Pagination: 1001-7 Citation Subset: IM |
Affiliation:
|
Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City, IA, USA. michael-ernst@uiowa.edu |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Antihypertensive Agents / therapeutic use* Blood Pressure / drug effects Chlorthalidone / therapeutic use* Combined Modality Therapy Diuretics / therapeutic use* Electrocardiography / drug effects* Follow-Up Studies Humans Hydrochlorothiazide / therapeutic use* Hypertension / drug therapy*, therapy Hypertrophy, Left Ventricular / epidemiology, etiology, physiopathology, prevention & control* Male Middle Aged Risk Factors Treatment Outcome |
| Grant Support | |
ID/Acronym/Agency:
|
R01 HL068140-01/HL/NHLBI NIH HHS; R01-HL68140/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
|
0/Antihypertensive Agents; 0/Diuretics; 58-93-5/Hydrochlorothiazide; 77-36-1/Chlorthalidone |
| Comments/Corrections | |
Comment In:
|
Hypertension. 2011 Dec;58(6):994-5
[PMID:
22025371
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Data sources on drug safety evaluation: a review of recent published meta-analyses.
Next Document: Genetic variants and blood pressure in a population-based cohort: the Cardiovascular Risk in Young F...