Evidence map›Paper›PMID 24956971›Full record

Trial reportHigh blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension2015

Should thiazide diuretics be given as first line antihypertensive therapy or in addition to other medications?

Valentina Trimarco, Raffaele Izzo, Teresa Migliore, Francesco Rozza, Marina Marino, Maria Virginia Manzi, Marina De Marco, Giovanni de Simone, Nicola De Luca

Abstract readComparative StudyMulticenter StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Valentina TrimarcoHypertension Research Center, Federico II University Hospital, via S. Pansini 5, bld. 2, 80131, Naples, Italy.
Raffaele Izzo
Teresa Migliore
Francesco Rozza
Marina Marino
Maria Virginia Manzi
Marina De Marco
Giovanni de Simone
Nicola De Luca

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe recommendation to start antihypertensive therapy with diuretics (D) might produce delay in blood pressure (BP) control and, possibly, increase cost/benefit ratio.

aimWe evaluate the effects of D in relation to the administration of other anti-hypertensive medications, in clinical practice.

methodsGeneral practitioners recruited 2,409 hypertensive patients with indication to antihypertensive therapy, who were randomized to start treatment with chlorthalidone (12.5-25  mg daily, group D) or any other single medications (excluding thiazides, group A). The patients have been followed for at least 2 years.

resultAmong the 2,409 patients recruited (42.5 % women), 1,205 were randomized in group D and 1,204 in group A, of which 1,051 (or 87 %) and 1026 (or 85 %) respectively, completed the study. The number of patients in optimal BP control was similar in the two groups (65.0 vs 64.0 %; p = NS). During follow-up, the group D had prescribed a slightly greater number of medications compared to the group A who added D as second line (2.3 vs 2.1; p < 0.0001). In particular group D took more β-blockers (27.1 vs 14.9 %; p < 0.0001) with a similar number of patients in optimal BP control (64.35 vs 63.9 %; p = NS).

conclusionThe beginning of antihypertensive therapy with diuretics is more often subject to the addition of one or more medications to obtain an effective blood pressure control, since the diuretic administered at the beginning of the antihypertensive regimen is only rarely associated with optimal blood pressure control.

Indexed as

Antihypertensive AgentsBlood PressureChlorthalidoneDrug Therapy, CombinationFemaleGeneral PracticeHumansHypertensionItalyMaleSodium Chloride Symporter InhibitorsTime FactorsTreatment OutcomeAntihypertensive AgentsChlorthalidoneSodium Chloride Symporter Inhibitors

Identifiers

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.