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Posted by on Jul 17, 2015 in Hypertension | 2 comments

In a nutshell

This study aimed to see if chlorthalidone is effective at lowering blood pressure in patients with poor kidney function. 

Some background

The function of the kidney is to filter the blood and remove unnecessary molecules into the urine. When kidney function is low there can be too much or too little of these molecules taken out of the body in the urine. Having high blood pressure increases the 'wear and tear' on the organs of the body. If kidney function is impaired, it is better to have low blood pressure. Having lower blood pressure makes it less likely that kidney function will get worse.

Chlorthalidone (Thalitone) is a very effective long-term treatment for high blood pressure. One of the benefits of chlorthalidone is that it has a longer duration of action then a lot of other anti-hypertensive medications. It can also help to clear excessive sodium from the body. Clearing excessive sodium from the body can help with symptoms such as edema (water retention).  However, it is not known whether chlorthalidone is safe and effective in the short-term for patients with low kidney function. 

Methods & findings

This study examined the safety and effectiveness of chlorthalidone in patients with both high blood pressure and low kidney function. 120 participants with blood pressure uncontrolled by other treatments were divided into 2 groups. The first group included patients with low kidney function. The second group included patients with normal kidney function. All patients were treated with chlorthalidone for 8 weeks. Each patient also continued the blood pressure medications used prior to the start of the study. Creatinine (a waste product filtered by the kidneys – low levels indicate kidney damage) levels were used to access kidney function.

Chlorthalidone was effective in lowering blood pressure in both groups. Systolic blood pressure (pressure when the heart is contracting) decreased by 19.2 mmHg in those with low kidney function and 21.6 mmHg in those with normal kidney function.

Both groups saw a decrease in average weight. The decrease in weight was larger in the group with poor kidney function (-0.88 kg) compared to those with normal kidney function (-0.22 kg). Creatinine levels increased by 14 mg/dL in the low kidney function group and by 0.07 mg/dL in the normal kidney function group.

Chlorthalidone was generally well tolerated. However, 5 patients left the trial due to low blood pressure. 

The bottom line

This study concluded that chlorthalidone was an effective treatment for hypertension in patients with low kidney function. The authors also concluded that it has the added benefit of aiding in weight loss due to water retention.

What’s next?

 If you are worried about kidney function, discuss blood pressure treatment options with your physician.

Published By :

Hypertension

Date :

Jan 06, 2014

Original Title :

Parallel-Group 8-Week Study on Chlorthalidone Effects in Hypertensives With Low Kidney Function.

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