Chlorthalidone

LONG BEACH, Calif., May 16, 2024 /PRNewswire/ -- A new analysis of a study comparing two commonly used medications, chlorthalidone (CTD) and hydrochlorothiazide (HCTZ), is set to be presented as a late-breaking presentation at the annual 2024 National Kidney Foundation Spring Clinical Meetings. Continue Reading The study, titled "Treatment with Chlorthalidone vs Hydrochlorothiazide and Renal Outcomes: The Diuretic Comparison Project (DCP)," conducted by a team of distinguished researchers from various institutions and led by Areef Ishani, MD MS, Minneapolis VA Health Care System Primary Care and Specialty Care Integrated Care Community (ICC) Director and Professor of Medicine, University of Minnesota provides crucial insights into the impact of these medications on renal health in hypertensive patients. New study comparing two commonly used medications set to be shared as a late-breaking presentation at NKF's Conference. Post this Hypertension, or high blood pressure, is a significant risk factor for the development and progression of chronic kidney disease (CKD). Previous research had hinted at potential differences in kidney outcomes between chlorthalidone and hydrochlorothiazide. This new study followed more than 12,000 participants for an average of 3.9 years. The study found no significant disparity in renal outcomes between patients treated with chlorthalidone and those treated with hydrochlorothiazide. Specifically, there was no marked difference observed in the primary composite renal outcome, including doubling of serum creatinine, a significant drop in estimated glomerular filtration rate (eGFR), or kidney failure requiring treatment (KFRT), between the two treatment groups. Furthermore, the study revealed that the total slope of eGFR change and the incidence of chronic kidney disease (CKD) were comparable between patients receiving chlorthalidone and hydrochlorothiazide, suggesting similar efficacy in preserving kidney function. The findings offer reassurance that both chlorthalidone and hydrochlorothiazide may be equally effective choices for managing hypertension without compromising renal health. About NKF Spring Clinical Meetings For the past 32 years, nephrology healthcare professionals from across the country have come to NKF's Spring Clinical Meetings to learn about the newest developments related to all aspects of nephrology practice; network with colleagues; and present their research findings. The NKF Spring Clinical Meetings is designed for meaningful change in the multidisciplinary healthcare teams' skills, performance, and patient health outcomes. It is the only conference of its kind that focuses on translating science into practice for the entire healthcare team. About Kidney Disease In the United States, more than 37 million adults are estimated to have kidney disease, also known as chronic kidney disease (CKD)—and approximately 90 percent don't know they have it. About 1 in 3 adults in the U.S. are at risk for kidney disease. Risk factors for kidney disease include: diabetes, high blood pressure, heart disease, obesity, and family history. People of Black or African American, Hispanic or Latino, American Indian or Alaska Native, Asian American, or Native Hawaiian or Other Pacific Islander descent are at increased risk for developing the disease. Black or African American people are about four times as likely as White people to have kidney failure. Hispanics experience kidney failure at about double the rate of White people. About NKF Professional Memberships Healthcare professionals can join NKF to receive access to tools and resources for both patients and professionals, discounts on professional education, and access to a network of thousands of individuals who treat patients with kidney disease. About the National Kidney Foundation The National Kidney Foundation is revolutionizing the fight to save lives by eliminating preventable kidney disease, accelerating innovation for the dignity of the patient experience, and dismantling structural inequities in kidney care, dialysis, and transplantation. NKF Website Instagram Facebook X SOURCE The National Kidney Foundation

A clinical trial found that two first-line treatments for high blood pressure were equally effective. A large VA clinical trial found that the blood pressure drug chlorthalidone (CTD) was not superior to hydrochlorothiazide (HCTZ) for the prevention of cardiovascular disease or non-cancer death. Both drugs are in a class of medications called thiazide diuretics, commonly known as water pills. They are used to help the body rid itself of excess fluid, which can lower blood pressure. The study was a first-of-its-kind pragmatic trial that was embedded in usual clinical care. As part of VA's clinical trials enterprise, it allowed participation from across the country with no additional staff. Also, all study procedures were done as part of routine clinical care. There was no additional burden placed on Veterans who participated in the study, including no extra visits. "Because of the number of Veterans VA cares for and our systemwide electronic medical record, we were able to embed this massive clinical trial within day-to-day care without any additional burden to the thousands of Veterans who volunteered for this study," said Rachel Ramoni, VA's chief research and development officer. "The result is important evidence of how these widely-used medications work in the real world." Current clinical guidelines say that CTD may be more effective than HCTZ to lower blood pressure, but this recommendation is unsupported by direct evidence. Both medications have been used for more than 50 years and each is considered a first-line treatment for hypertension. "In 2020, Medicare reported that approximately 1.5 million people were prescribed CTD compared to 11.5 million prescribed HCTZ, despite guideline recommendations," said principal investigator Dr. Areef Ishani, director of the Minneapolis VA Health Care System's Primary Care and Specialty Care Integrated Care Community. "This discrepancy between clinical guidelines and real-world usage is possibly related to the belief that CTD has a greater risk of adverse effects without clear evidence for differences in cardiovascular outcomes." The Diuretic Comparison Project (CSP 597) is a large pragmatic clinical trial that was conducted at 537 VA medical centers and community clinics in the U.S. The trial enrolled more than 4,000 providers and 13,500 Veterans with high blood pressure who were taking HCTZ at baseline. Study participants were randomized to stay on their current dose of HCTZ or take an equivalent dose of CTD. Ninety-five percent of study participants were taking a lower dose of HCTZ, so the main study comparison was 12.5 mg CTD to 25 mg HCTZ. The team found no difference between the two drugs, at these lower doses, for the prevention of cardiovascular disease or non-cancer death, which included heart attack, stroke, heart failure, or lack of blood flow requiring medical intervention. There was a slight increase in the risk for low potassium in the CTD group, which quickly resolved with potassium supplements. "We were able to compare two commonly prescribed generic drugs using a low-cost methodology," said Ishani. "This trial has shown that large, embedded trials are operationally feasible. They can be incorporated into the clinical workflow of providers by leveraging the electronic health record and other existing infrastructure." The study was funded by the VA Cooperative Studies Program. The study results were published online December 14, 2022, by the New England Journal of Medicine.