HYDROCHLOROTHIAZIDE AND CHLORTHALIDONE ON BLOOD PRESSURES

氢氯噻嗪和氯噻酮对血压的影响

• 批准号: 7377016
• 负责人: MICHAEL E ERNST
• 金额: $ 0.13万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-03-01 至 2007-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7377016
• 关键词: HYDROCHLOROTHIAZIDE; CHLORTHALIDONE; BLOOD; PRESSURES

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Recent evidence from the Antihypertensive and Lipid-Lowering to Prevent Heart Attack Trial (ALLHAT) suggests initial therapy with a thiazide-type diuretic confers significantly higher reductions in stroke and coronary heart disease events compared to newer antihypertensive agents such as angiotensin-converting enzyme inhibitors and calcium channel blockers. Chlorthalidone, the thiazide-type diuretic utilized in ALLHAT, has traditionally been the diuretic utilized in many of the landmark clinical trials in hypertension. However, hydrochlorothiazide (HCTZ) is the thiazide diuretic typically used in clinical practice in the United States. Although most clinicians assume HCTZ and chlorthalidone are clinically interchangeable, there is a lack of data comparing these agents directly to one another. This is an 8-week, open-label, crossover trial comparing the antihypertensive effects of HCTZ versus chlorthalidone on both office-based and ambulatory blood pressures. Men and women with essential hypertension and meeting inclusion criteria will be recruited from two primary care practices at the University of Iowa Family Care Center. After a 2-4 week washout period during which time patients will return for weekly office blood pressure measurements, patients will then undergo a baseline ambulatory blood pressure monitoring session and be randomized to either HCTZ 25 mg/d or chlorthalidone 12.5 mg/d. Patients will return biweekly for office blood pressure measurements, and/or laboratory measurements, and/or dosage titration (to a max dose of 25 mg for chlorthalidone and 50 mg of HCTZ). Ambulatory blood pressure monitoring will be repeated at week 8. Following completion of the first arm of the study, patients will again undergo a second 2-4 week washout period and proceed into the opposite arm of the study which is identical to the first arm but with the opposite medication.

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子弹和调查员（PI）可能已经从其他NIH来源获得了主要资金，因此可以在其他清晰的条目中代表。列出的机构适用于该中心，这不一定是调查员的机构。从降压和降低脂质的降低和降低脂质的最新证据以防止心脏病发作试验（Allhat）表明，与新的抗型药物（如抗血管敏感剂量抑制剂和钙化剂量抑制剂）相比，中风和冠心病事件的噻嗪类型利尿剂的初步疗法明显更高。传统上，氯丁替酮是在Allhat中使用的噻嗪类型利尿剂，是在高血压中的许多地标临床试验中使用的利尿剂。但是，氢氯噻嗪（HCTZ）是美国通常用于临床实践中的噻嗪类利尿剂。尽管大多数临床医生认为HCTZ和氯噻酮在临床上是可以互换的，但缺乏将这些药物直接与彼此进行比较的数据。这是一项为期8周的开放标签，跨界试验，比较了HCTZ与氯噻酮对基于办公室和卧床血压的抗高血压作用。具有基本高血压和满足纳入标准的男性和女性将从爱荷华大学家庭护理中心的两种初级保健实践中招募。在经过2-4周的洗涤期之后，患者将每周进行办公室血压测量结果返回，然后患者将进行基线卧床血压监测，并随机分为HCTZ 25 mg/d或氯噻酮12.5 mg/d。患者将每两周返回办公室血压测量和/或实验室测量和/或剂量滴定（氯噻酮的最高剂量为25 mg，HCTZ的最高剂量为25 mg）。卧床血压监测将在第8周重复。研究的第一臂完成后，患者将再次进行第二次2-4周的冲洗期，并进入研究的另一臂，该研究与第一臂相同，但用相反的药物相同。