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ȣ - 550035 137 |
Comparison of the efficacy between hydrochlorothiazide and chlorthalidone combined with candesartan on central aortic pressure in patients with never-treated hypertension |
가톨릭대학교 |
권범준, 장성원, 최규영, 김동빈, 조은주, 임상현, 김재형 |
Backgroud The aim of this study was to compare the effects between hydrochlorothiazide (HCTZ) and chlorothalidone (CHTL) when used in combination with candesartan on central aortic blood pressure (BP). Methods We conducted a prospective, randomized, open-label, 8-week active treatment, blinded end point study with cross-over design comparing HCTZ (25mg/day) and CHTL (12.5mg/day) combined with candesartan (CDRT, 8mg/day) in never-treated hypertensive patients. Central BP by radial tonometry, aortic pulse wave velocity, and augmentation index were measured. Twenty seven patients (age: 50±9 years, male:44.4%) completed both treatment. Results Central BP after 8-week of active treatment was not significantly different between CDRT/HCTZ and CDRT/CHTL treatment (Table). CDRT/CHTL combination showed significant reduction in the aortic pulse wave velocity as compared with CDRT/HCTZ combination. Conclusions CHTL, at half the dose of HCTZ, was as potent as HCTZ in lowering central aortic pressure when combined with candesartan.
|
Variables |
HCTZ/candesartan
combination |
CHTL/candesartan
combination |
P
|
Central SBP (mmHg) |
|
|
|
Baseline (0-week) |
137 ± 16 |
138 ± 14 |
0.702 |
End of study (8-week) |
123 ± 12 |
122 ± 13 |
0.687 |
Change (95% CI) |
-14 (-22 to -6)* |
-16 (-23 to -9)* |
0.645 |
Central DBP (mmHg) |
|
|
|
Baseline (0-week) |
82 ± 11 |
85 ± 9 |
0.688 |
End of study (8-week) |
77 ± 10 |
75 ± 8 |
0.270 |
Change |
-6 (-10 to -1)* |
-10 (-14 to -6)* |
0.148 |
Central PP (mmHg) |
|
|
|
Baseline (0-week) |
54 ± 11 |
53 ± 10 |
0.347 |
End of study (8-week) |
46 ± 9 |
47 ± 9 |
0.595 |
Change (95% CI) |
-8 (-13 to -3)* |
-6 (-10 to -2)* |
0.501 |
Pulse wave velocity (m/s) |
|
|
|
Baseline (0-week) |
1377 ± 192 |
1439 ± 190 |
0.605 |
End of study (8-week) |
1382 ± 220 |
1321 ± 194 |
0.173 |
Change (95% CI) |
5 (-77 to 87) |
-118 (-200 to -36)*,† |
0.033 |
Augmentation index (%) |
|
|
|
Baseline (0-week) |
83 ± 11 |
79 ± 11 |
0.143 |
End of study (8-week) |
78 ± 15 |
79 ± 13 |
0.849 |
Change (95% CI) |
-5 (-11 to 0) |
0 (-5 to 4) |
0.150 |
SBP, systolic blood pressure; DBP, diastolic blood pressure; PP, pulse pressure. *P < 0.05 vs. baseline and †P < 0.05 vs. group 1.
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