Trial reportHypertension (Dallas, Tex. : 1979)2011
Long-term effects of chlorthalidone versus hydrochlorothiazide on electrocardiographic left ventricular hypertrophy in the multiple risk factor intervention trial.
Trial report in Hypertension (Dallas, Tex. : 1979), 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 59 citations in OpenAlex.
- Hydrochlorothiazide vs chlorthalidone, indapamide, and potassium-sparing/hydrochlorothiazide diuretics for reducing left ventricular hypertrophy: A systematic review and meta-analysis.Journal of clinical hypertension (Greenwich, Conn.) · 2018Pooled it
- Trial
- Chlorthalidone for Hypertension in Advanced Chronic Kidney Disease.The New England journal of medicine · 2021Trial
- Electrocardiographic measures of left ventricular hypertrophy in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial.Journal of the American Society of Hypertension : JASH · 2016Trial
- A randomized trial of the efficacy and safety of azilsartan medoxomil combined with chlorthalidone.Journal of the renin-angiotensin-aldosterone system : JRAASTrial
- An Update on Refractory Hypertension.Current hypertension reports · 2022Review
- The Road to Better Management in Resistant Hypertension-Diagnostic and Therapeutic Insights.Pharmaceutics · 2021Review
- A Contemporary Approach to Hypertensive Cardiomyopathy: Reversing Left Ventricular Hypertrophy.Current hypertension reports · 2020Review
- Comparison of Cardiovascular and Safety Outcomes of Chlorthalidone vs Hydrochlorothiazide to Treat Hypertension.JAMA internal medicine · 2020Observational
- Compelling therapy of LVH: straight (and not-so-straight) inferences from evidence.Clinical hypertension · 2019Article
- Diuretics in the treatment of hypertension.Pediatric nephrology (Berlin, Germany) · 2016Review
- Hydrochlorothiazide is not the most useful nor versatile thiazide diuretic.Current opinion in cardiology · 2015Review
- Not just chlorthalidone: evidence-based, single tablet, diuretic alternatives to hydrochlorothiazide for hypertension.Current hypertension reports · 2015Article
- Thiazide Diuretics in Chronic Kidney Disease.Current hypertension reports · 2015Review
- Which thiazide to choose as add-on therapy for hypertension?Integrated blood pressure control · 2014Review
- Chlorthalidone: mechanisms of action and effect on cardiovascular events.Current hypertension reports · 2013Review
- The comparative effectiveness of hydrochlorothiazide and chlorthalidone in an observational cohort of veterans.Journal of clinical hypertension (Greenwich, Conn.) · 2012Article
- Should two-drug initial therapy for hypertension be recommended for all patients?Current hypertension reports · 2012Review
- Review
- Article
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
Abstract
Chlorthalidone (CTD) reduces 24-hour blood pressure more effectively than hydrochlorothiazide (HCTZ), but whether this influences electrocardiographic left ventricular hypertrophy is uncertain. One source of comparative data is the Multiple Risk Factor Intervention Trial, which randomly assigned 8012 hypertensive men to special intervention (SI) or usual care. SI participants could use CTD or HCTZ initially; previous analyses have grouped clinics by their main diuretic used (C-clinics: CTD; H-clinics: HCTZ). After 48 months, SI participants receiving HCTZ were recommended to switch to CTD, in part because higher mortality was observed for SI compared with usual care participants in H-clinics, whereas the opposite was found in C-clinics. In this analysis, we examined change in continuous measures of electrocardiographic left ventricular hypertrophy using both an ecological analysis by previously reported C- or H-clinic groupings and an individual participant analysis where use of CTD or HCTZ by SI participants was considered and updated annually. Through 48 months, differences between SI and usual care in left ventricular hypertrophy were larger for C-clinics compared with H-clinics (Sokolow-Lyon: -93.9 versus -54.9 μV, P=0.049; Cornell voltage: -68.1 versus -35.9 μV, P=0.019; Cornell voltage product: -4.6 versus -2.2 μV/ms, P=0.071; left ventricular mass: -4.4 versus -2.8 g, P=0.002). At the individual participant level, Sokolow-Lyon and left ventricular mass were significantly lower for SI men receiving CTD compared with HCTZ through 48 months and 84 months of follow-up. Our findings on left ventricular hypertrophy support the idea that greater blood pressure reduction with CTD than HCTZ may have led to differences in mortality observed in the Multiple Risk Factor Intervention Trial.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.