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Posted by on Aug 26, 2018 in Hypertension | 0 comments

In a nutshell

This study investigated if hydrochlorothiazide and alternative thiazide-type diuretics (CHIPs) can treat left ventricular hypertrophy (LVH) in patients with hypertension. They found that CHIPs effectively treat LVH in patients with hypertension.

Some background

Left ventricular hypertrophy (LVH) is a condition caused by an enlarged heart wall. It is common in patients with high blood pressure (hypertension). Patients with LVH are at a greater risk of heart attack, heart failure, and death. Treating LVH reduces this risk.

Thiazide-type diuretics (TTDs) are medications to treat hypertension. They work by increasing the amount of water and salt eliminated from the body. Hydrochlorothiazide (HCTZ) is a commonly prescribed TTD to treat hypertension. Alternative TTDs include Chlorthalidone, Indapamide, and Potassium-sparing/HCTZ diuretics, (CHIPs). Renin-angiotensin system inhibitors (RASIs) are used in patients with hypertension to treat LVH. These include angiotensin-converting enzyme inhibitors and angiotensin receptor blockers. Previous studies have not identified TTDs as a suitable treatment for LVH. However, these studies did not analyze each TTD individually. It is unclear if HCTZ and CHIPs are as useful to treat LVH, as RASIs.

Methods & findings

This study included 12 clinical trials. In these reports, a total of 1005 patients were treated with either RASIs or TTDs (HCTZ or CHIPs). Reductions of the left heart wall were measured to determine if LVH was successfully treated.

RASIs were most effective at treating LVH compared to TTDs overall. When compared to HCTZ alone, RASIs were more effective. However, CHIPS were 37% more effective than RASIs in reducing LVH.

The bottom line

The authors concluded that alternative thiazide-type diuretics can effectively treat LVH in patients with hypertension.

The fine print

This study compared results from several different clinical trials with different protocols. This study did not report on the safety of any drug treatment. Although CHIPs may be a useful treatment for LVH, further investigation is needed.

What’s next?

If you have any concerns regarding LVH and hypertension please discuss this with your physician.

Published By :

Journal of hypertension

Date :

Feb 20, 2018

Original Title :
Hydrochlorothiazide and alternative diuretics versus renin-angiotensin system inhibitors for the regression of left ventricular hypertrophy: a head-to-head meta-analysis.
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