High blood pressure patients, stick with your diuretic meds

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Good news for patients with elevated systolic blood pressure. The results of a 22-year follow-up on a randomized trial show that the diuretic drug chlorthalidone improved all-cause mortality among patients with this condition. The new analysis of the trial data, which dated back to 1984, has found that chlorthalidone, used to treat high blood pressure, was especially effective at reducing the toll of cardiovascular events, including sudden death.

The original trial, known as the Systolic Hypertension in the Elderly Program (SHEP), recruited over 4,500 patients age 60 and older with isolated systolic hypertension (systolic BP of 160 mm Hg or higher with normal diastolic BP) and assigned them to receive either chlorthalidone or placebo for 4.5 years. Yet despite a decrease in the risk of stroke and hospitalizations for adverse cardiovascular events, the SHEP trial failed to demonstrate significant improvement in survival among patients in the treatment group during the initial study interval.

Now, however, an observational follow-up on data from the SHEP trial, led by researchers from the University of Medicine and Dentistry of New Jersey, finds that patients taking chlorthalidone over the long term experienced a gain of one extra day of life expectancy for every month of treatment. Published in the Journal of the American Medical Association, the study also found that cardiovascular mortality was lower in the treatment group (28.3 percent) than in the placebo arm (31 percent), nearly two decades after the original treatment study.

As ACSH s Dr. Gilbert Ross points out, Systolic hypertension is one of the most common causes of morbidity and mortality in our country and in much of the Western world. The results of this study are, therefore, quite important. He adds, Perhaps more health care professionals will start prescribing diuretic-based drugs to their high blood pressure patients, and, in return, perhaps these patients will better adhere to this effective treatment regimen.