Effectiveness of chlorthalidone/amiloride versus losartan in patients with stage I hypertension and diabetes mellitus: r
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ORIGINAL ARTICLE
Effectiveness of chlorthalidone/amiloride versus losartan in patients with stage I hypertension and diabetes mellitus: results from the PREVER‑treatment randomized controlled trial Flávio D. Fuchs1 · Luiz C. N. Scala2 · José F. Vilela‑Martin3 · Paul K. Whelton4 · Carlos E. Poli‑de‑Figueiredo5 · Ricardo Pereira E Silva6 · Miguel Gus1 · Luiz A. Bortolotto7 · Fernanda M. Consolim‑Colombo7 · Rosane P. Schlatter8 · José E. Cesarino9 · Iran Castro10 · José A. Figueiredo Neto11 · Hilton Chaves12 · André A. Steffens13 · João G. Alves14 · Andréa A. Brandão15 · Marcos R. de Sousa16 · Paulo C. Jardim17 · Leila B. Moreira8 · Roberto S. Franco18 · Marco M. Gomes19 · Abrahão Afiune Neto20 · Felipe C. Fuchs1 · Dario C. Sobral Filho21 · Antônio C. Nóbrega22 · Fernando Nobre23 · Otávio Berwanger24 · Sandra C. Fuchs1 Received: 3 August 2020 / Accepted: 23 September 2020 © Springer-Verlag Italia S.r.l., part of Springer Nature 2020
Abstract Aims To compare the blood pressure (BP)-lowering efficacy of a chlorthalidone/amiloride combination pill with losartan, during initial management of JNC 7 Stage I hypertension in patients with type 2 diabetes mellitus. Methods In an a priori subgroup analysis of a randomized, double-blind, controlled trial, volunteers aged 30–70 years, with stage I hypertension and diabetes mellitus, were randomized to 12.5/2.5 mg of chlorthalidone/amiloride (N = 47) or 50 mg of losartan (N = 50), and followed for 18 months in 21 clinical centers. If BP remained uncontrolled after three months, study medication dose was doubled, and if uncontrolled after six months, amlodipine (5 and 10 mg) and propranolol (40 and 80 mg BID) were added as open label drugs in a progressive fashion. Results Systolic BP decreased to a greater extent in participants allocated to diuretics compared to losartan (P
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