Treatment of Isolated Systolic Hypertension: The SHELL Study Results

Malacco, Ettore; Mancia, Giuseppe; Rappelli, A; Menotti, Alessandro; Zuccaro, M; Coppini, Alessandro

doi:10.1080/08037050310009545

Cited by 89 publications

(41 citation statements)

References 4 publications

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“…As the guidelines partly used the same studies, this resulted in 21 trials for analysis, including two recent trials not yet cited in these guidelines [12,13,17]. Together with additional references to studies' design, protocol, or patients' characteristics 47 articles were analyzed [12e58].…”

Section: Resultsmentioning

confidence: 99%

Hypertension patients participating in trials differ in many aspects from patients treated in general practices

Uijen

Bakx

Mokkink

et al. 2007

Journal of Clinical Epidemiology

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Section: Resultsmentioning

confidence: 99%

Hypertension patients participating in trials differ in many aspects from patients treated in general practices

Uijen

Bakx

Mokkink

et al. 2007

Journal of Clinical Epidemiology

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“…10 Indeed, monotherapy based on CCBs has demonstrated to provide sustained antihypertensive efficacy and to reduce cardiovascular and renal complications compared to other antihypertensive drug classes. [37][38][39][40][41][42] In those patients with hypertension who do not achieve satisfactory BP control under monotherapy, or in those with high or very high cardiovascular risk profile, a combination strategy based on the use of 2 classes of antihypertensive drugs, including either ARBs or ACE inhibitors plus CCBs or thiazide diuretics (dual combination therapy) should be used. Randomized clinical trials [43][44][45] and large meta-analyses 46,47 confirmed that these combination strategies are characterized by an antihypertensive efficacy about 5 times greater than the doubling of the dose of each monotherapy.…”

Section: Current Recommendations For Hypertension Treatment and Controlmentioning

confidence: 99%

Calcium Channel Blockers and Hypertension

Battistoni

Passerini

Musumeci

et al. 2014

J Cardiovasc Pharmacol Ther

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Effective treatment of high blood pressure (BP) represents a key strategy for reducing the burden of hypertension-related cardiovascular and renal diseases. In spite of these well-established concepts, hypertension remains poorly controlled worldwide. In order to improve BP control in patients with hypertension, several interventions have been proposed, among which (1) preferred use of more effective, sustained, and well-tolerated antihypertensive drug aimed to ensure adherence to prescribed medications and (2) extensive use of rational, integrated, and synergistic combination therapies, even as first-line strategy, aimed to achieve the recommended BP targets. Within the possible antihypertensive drug classes currently available for the clinical management of hypertension, both in monotherapy and in combination therapy, drugs inhibiting the renin-angiotensin system and calcium channel blockers (CCBs) have demonstrated to be effective and safe in lowering BP levels and achieving the recommended BP targets with a good tolerability profile. In particular, CCBs have been one of the most widely used classes of antihypertensive agents in the last 20 years, based on their effectiveness in reducing BP levels, good tolerability, and abundant evidence on reducing cardiovascular and renal consequences of hypertension. This article provides an updated overview of the evidence supporting the use of CCBs-based antihypertensive regimen, both in monotherapy and in combination therapies with different classes of antihypertensive drugs.

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“…There were three papers reporting bendrofluazide 9-11 outcomes, two papers using chlorothiazide, 12,13 five papers reporting five outcomes for chlorthalidone, [14][15][16][17][18] 10 papers using hydrochlorothiazide 9,11,[19][20][21][22][23][24][25][26] and one paper reporting on indapamide 27 (table 1). two of these studies used bendrofluazide or hydrochlorothiazide.…”

Section: Resultsmentioning

confidence: 99%

Should we switch from bendrofluazide to chlorthalidone as the initial treatment for hypertension? A review of the available medication

Arroll

Wallace

2017

J Prim Health Care

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INTRODUCTION Thiazide diuretics are commonly prescribed in the treatment of hypertension. However, thiazide diuretics may not all be equal in their ability to reduce cardiovascular disease outcomes. AIM To determine if bendroflumethiazide/bendrofluazide, the most commonly used diuretic for hypertension in New Zealand, is as effective as other diuretics in terms of cardiovascular disease outcomes. METHODS Using recent reviews of thiazide-like (chlorthalidone or indapamide) and thiazide-type diuretics (hydrochlorothiazide and bendrofluazide) and a separate search of bendrofluazide, data on cardiovascular disease outcomes was extracted. RESULTS Nineteen relevant papers with 21 comparisons were found. All thiazide-based diuretics have been reported in at least one trial showing them to be more effective than placebo for cardiovascular disease outcomes, with the exception of chlorothiazide. There were no comparisons of bendrofluazide alone with other medications, but there were two studies with either bendrofluazide or hydrochlorothiazide compared with β-blockers; however, the pooled relative risk (RR) was not significant (RR = 1.10 (95% CI, 0.84–1.43)). For chlorthalidone, there were four comparisons with other medications, and the summary RR was statistically significant for cardiovascular disease outcomes (RR = 0.91 (95% CI, 0.85–0.98)). Chlorthalidone was significantly more effective for some cardiovascular disease outcomes when compared with doxazosin, amlodipine and lisinopril. CONCLUSIONS All thiazide-based medicines available in New Zealand are effective in terms of cardiovascular disease outcomes compared with placebo when used for treating hypertension, with the exception of chlorothiazide. Of the diuretics available in New Zealand for hypertension, only chlorthalidone has been shown to be more effective than other blood pressure-lowering medicines. It may be time to change from using bendrofluazide and start using chlorthalidone as a treatment for hypertension.

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Treatment of Isolated Systolic Hypertension: The SHELL Study Results

Abstract: In elderly patients with isolated systolic hypertension, administration of lacidipine or chlorthalidone markedly reduced systolic blood pressure with no difference in the incidence of cardiovascular events and total mortality.

Cited by 89 publications

References 4 publications

Hypertension patients participating in trials differ in many aspects from patients treated in general practices

Hypertension patients participating in trials differ in many aspects from patients treated in general practices

Calcium Channel Blockers and Hypertension

Should we switch from bendrofluazide to chlorthalidone as the initial treatment for hypertension? A review of the available medication

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