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At least 163 records · Page 9Linked to original sources

PubMed1980

Trial of atenolol and chlorthalidone for hypertension in black South Africans.

Twenty-four black patients (Zulus) with hypertension participated in a double-blind, placebo-controlled cross-over trial of the efficacy of a beta-blocking agent (atenolol) 100 mg once daily as compared with chlorthalidone 25 mg once daily. The two drugs were also given combined at these doses and the effects compared with those of the drugs given alone. Atenolol as sole treatment had no appreciable effect on blood pressure as compared with placebo. Chlorthalidone produced a small decrease, but this was not statistically significant. Combining the two drugs, however, produced a significant reduction in blood pressure (mean lying blood pressure p < 0.001; mean standing blood pressure p < 0.0002). These findings suggest that beta-blockers should not be regarded as baseline treatment of hypertension in blacks.

Atenolol↗

PubMed1991

Comparative effects of enalapril, atenolol and chlorthalidone on blood pressure and kidney function of diabetic patients affected by arterial hypertension and persistent proteinuria.

Arterial hypertension and proteinuric nephropathy are common features in diabetic patients. In streptozotocin-diabetic rats, it has been possible to reduce the blood pressure and proteinuria by converting enzyme inhibitors, and so slowing the decline of kidney function. These results have been confirmed in diabetic patients affected by arterial hypertension and persistent proteinuria. However, up to now it has not been clear if these favorable renal effects are related specifically to converting enzyme inhibition. In the attempt to clarify this last point, from a practical as well as from a speculative point of view, 12 type 2 diabetic outpatients affected by mild to moderate arterial hypertension and persistent macroalbuminuria (greater than 250 mg/daily, at least on three consecutive occasions) without any other signs of renal diseases were studied. In a randomized sequence and in a double blind fashion, after a washout period of 3 weeks, the patients underwent pharmacological treatment which consisted of enalapril 20 mg o.d., chlorthalidone 12.5 mg o.d., atenolol 50 mg o.d. and placebo o.d. Each treatment lasted 45 days. Kidney function, blood pressure and heart rate were checked at the beginning and at the end of each treatment, while urinary albumin excretion was measured at the end of the 4th, 5th, and 6th week of each treatment. Blood pressure significantly decreased in a similar fashion after each active treatment, while kidney function did not change significantly. Urinary albumin excretion rate significantly decreased after enalapril and atenolol, but did not change after chlorthalidone. According to these results we can hypothesize that the inhibition of tissue angiotensin formation and its related change on the glomerular permeability, rather than renal and systemic hemodynamic features, seem to be the common mechanisms by which both enalapril as well as atenolol decrease the albuminuria in our patients.

Atenolol↗

PubMed2003

Hydrochlorothiazide versus chlorthalidone: evidence supporting their interchangeability.

Thiazide diuretics are one of the preferred pharmacologic treatments for hypertension. Hydrochlorothiazide and chlorthalidone have been the 2 most commonly used diuretics in major clinical trials. Treatment guidelines and compendia often consider these 2 drugs interchangeable agents within the class of thiazide or thiazide-like diuretics. Many sources list them as equipotent. Despite these beliefs, there is some suggestion that cardiovascular outcomes are not necessarily the same with these 2 drugs. We conducted a literature search from 1960 to 2003 to identify studies that evaluated the pharmacokinetic and blood pressure-lowering effects of these 2 agents. There are significant pharmacokinetic and pharmacodynamic differences between these diuretics. Chlorthalidone is approximately 1.5 to 2.0 times as potent as hydrochlorothiazide, and the former has a much longer duration of action. Whether these pharmacokinetic and pharmacodynamic features cause differences in outcomes is not known.

Antihypertensive Agents↗

PubMed1980

The antihypertensive and biochemical effects of hydrochlorothiazide/amiloride (Moduretic) versus chlorthalidone.

In an open two-period crossover study hydrochlorothiazide/amiloride and chlorthalidone were compared with regard to their anti-hypertensive and biochemical properties in ambulatory patients with mild to moderate hypertension. Twenty-five out of twenty-six patients completed the study. In the chlorthalidone group plasma potassium was consistently lower than in the hydrochlorothiazide/amiloride group, the difference achieved significance at 8 and 12 weeks after the start of treatment. With regard to the hypertension and other parameters no statistically significant differences were found.

Adult↗

PubMed1982

A fixed combination of metoprolol slow-release and chlorthalidone, given once daily, in the long-term treatment of arterial hypertension.

A fixed combination of metoprolol slow-release 200 mg and chlorthalidone 25 mg was given once daily over a 3 months period in forty out-patients with mild-to-moderate arterial hypertension stage I or II WHO. The combination elicited a clear-cut antihypertensive effect lasting at least 24 hours after drug. As compared with pre-treatment values, systolic and diastolic blood pressures were gradually reduced within the first month of treatment, remaining nearly constant in the following 2 months. Treatment was well tolerated by all patients. Neither serum potassium nor any other laboratory test (creative, glucose, uric acid, etc) showed significant changes. In conclusion, slow-release metoprolol fixed association with chlorthalidone provides a safe and effective treatment of arterial hypertension even on a long-term basis. The once daily dosing schedule may considerably improve patient's compliance.

Adult↗

PubMedDate not supplied

Simultaneous determination of chlorthalidone and spironolactone with univariate and multivariate calibration: wavelength range selection.

Chlorthalidone and spironolactone were determined simultaneously with the aid of univariate and multivariate calibration methods. Univariate calibration was performed by the zero-crossing and derivative ratio spectrum methods. Extensive spectral overlap and the scarcity of wavelengths in derivative spectra allowing one analyte to be distinguished and quantitated in the presence of the other gave rise to poor results that called for multivariate calibration. Partial least-squares regression was used in combination with a suitable method for selecting the optimum wavelength range and number of factors for analysis. The ensuing method was applied to simultaneous determination of chlorthalidone and spironolactone in a commercially available pharmaceutical preparation. The results were validated by high-performance liquid chromatography.

Antihypertensive Agents↗

PubMed1975

Combined clonidine-chlorthalidone therapy in hypertension. Two years' experience in 30 patients.

The efficacy and safety of the antihypertensive drug, clonidine, were tested by open-label trial in 30 ambulatory, hypertensive patients who were concomitantly receiving the diuretic, chlorthalidone. This combined treatment followed several weeks of base line treatment with the diuretic alone. In both the recumbent and the upright position, clonidine potentiated the blood pressure-lowering effect of chlorthalidone to a noticeable degree; with combined treatment, the reductions in systolic and diastolic pressures were from 12.9% to 16.4% greater. Side-effects, consisting mostly of drowsiness and dryness of mouth, were mild and were observed mainly at the beginning of clonidine therapy. Orthostatic hypotension or weakness was experienced by 3 patients, but it subsided after dose adjustment in two of them. The drug combination was well suited for long-term management of patients with hypertension of all degrees of severity.

Adult↗

PubMedDate not supplied

Determination of the enantiomerization barrier of chlorthalidone by dynamic electrokinetic chromatography and computer simulation.

Dynamic electrokinetic chromatography (DEKC) and computer simulation have been used to determine the enantiomerization barrier of the drug chlorthalidone, which is commonly employed as a diuretic. The separation of enantiomers was performed in an aqueous 100 mM citric acid/phosphate buffer system at pH 5 containing 12.5 mg/mL carboxymethyl-beta-cyclodextrin and dimethyl-beta-cyclodextrin each as a dual chiral recognition system. The enantiomerization that occurred during separation resulted in a peak distortion, i.e., plateau formation and peak broadening. The interconversion profiles were simulated with ChromWin software, which is based on the theoretical plate as well as on the stochastic model using the experimental data plateau height, hplateau; peak width at half height, Wh, and total retention time, tR. Peak form analysis yielded the rate constants, k1 and k(-1) as well as the kinetic activation parameters, deltaG++, deltaH++, and deltaS++ of the enantiomerization reaction of chlorthalidone 1. At 37.5 degrees C, the enantiomerization barrier, deltaG++, was determined to be 100.6 +/- 0.4 kJ/mol(-1); the activation parameters by temperature-dependent measurement, deltaH++ = 69.2 +/- 0.2 kJ/mol , deltaS++ = -101 +/- 6 J K(-1) mol(-1) and the half-life, tau, was found to be approximately 2.5 hr.

Chemical Phenomena↗

PubMed1990

Thin layer densitometry in the quantitative assay of drugs. Note V--Assay of reserpine and chlorthalidone in the presence of the potential impurities of their solid pharmaceutical forms.

Densitometric detection of compounds separated by thin layer was applied to the assay of a mixture of reserpine and chlorthalidone and their possible impurities. The method of analysis gave satisfactory results in the quality control of pharmaceutical preparations. Good results were obtained in urine tests for the detection of chlorthalidone, reserpine and methylreserpate. The times for the development of fluorescence in reserpine and methylreserpate directly in the chromatographic plate, are also described.

Chlorthalidone↗

PubMed1990

Effects on casual and 24-h ambulatory blood pressure of slow-release nicardipine and chlorthalidone in arterial essential hypertension: double-blind, crossover study.

The antihypertensive effect of slow-release (SR) nicardipine (40 mg twice a day) and chlorthalidone (25 mg once a day), was evaluated in 36 patients with mild to moderate hypertension by casual and 24-h BP monitoring. After 2-week placebo wash-out, patients were treated for 8 weeks with one of the two drugs, according to a double-blind design. Successively, after other 2 weeks of placebo, they underwent a crossover treatment for other 8 weeks. Both drugs were efficacious in reducing BP. The greater activity of SR nicardipine was revealed by: the effect on casual BP, with the higher number of normalized patients; a greater reduction of 24-h BP; a greater influence on BP variability, assessed by mean standard variation and variation coefficient; the lower levels of linear regression between HR and both systolic and diastolic BP; the reduced per cent incidence of abnormal levels of both systolic and diastolic BP during 24 h. Both drugs were well tolerated, with a low incidence of side effects and absence of alterations of biochemical parameters, a part of 3 cases of ipokalemia induced by chlorthalidone. In conclusion, SR nicardipine is considered to be a safe and active first-choice drug for the treatment of mild to moderate hypertension.

Adult↗

PubMed1989

Long-term antihypertensive efficacy of ketanserin plus chlorthalidone.

The long-term antihypertensive efficacy of a combination of ketanserin (20 mg), an S2 antagonist with alpha 1 blocking activity, and chlorthalidone (25 mg), given o.d., was evaluated in fifteen patients with primary hypertension of mild to moderate degree, aged 45-65 years, up to a 12-month observation period. Systolic (SBP) and diastolic (DBP) blood pressure, and heart rate (HR) were measured by an automatic recorder (Sentron Bard Biomedical) twice at rest after 5 min in a supine position and after 2 and 5 min in an upright position, 24 h after the last antihypertensive dose. Thirteen patients completed the study whilst two were lost to the follow-up. A significant reduction was observed in both SBP and DBP at rest. In particular, SBP was reduced from 167 +/- 17 mmHg to 152 +/- 21 mmHg (p less than 0.01) after 1 month of therapy and was kept constant at this level throughout the observation period. DBP was also reduced from the first control [99 +/- 7 vs. 90 +/- 9 mmHg (p less than 0.01)] without any increase during the follow-up. HR was unchanged throughout the study. Four patients had dizziness and orthostatic hypotension after the first dose of the drug combination but were able to continue the study without further adverse reactions. These data support the conclusion that long-term treatment with the combination of a small dose of ketanserin and chlorthalidone is able to reduce systolic and diastolic blood pressure, without remarkable untoward side-effects.

Adult↗

PubMed1988

Effects of chronic administration of the fixed combination slow-release oxprenolol-chlorthalidone on left ventricular hypertrophy in hypertensive patients. Echocardiographic study.

To evaluate the effects of the chronic administration of the fixed combination slow-release, oxprenolol 160 mg and chlorthalidone 20 mg on left ventricular hypertrophy, ten hypertensive out-patients, with left ventricular hypertrophy documented by left ventricular mass index (LVMI) greater than 130 g/m2, were studied. After a two-week placebo period, patients were given the study medication, once daily for six months. Blood pressure and heart rate were measured, 24 h after-dosing, at the end of placebo and thereafter every month. A m-mode echocardiographic examination was performed at the end of the placebo period, after 1 month of active treatment and at the end of the study. In comparison with placebo, the study medication induced a significant reduction (p less than 0.01) of systolic and diastolic blood pressure, 24 h after dosing, after 1 month of treatment (from 181.0 +/- 18.5/108.5 +/- 12.0 to 146.5 +/- 10.8/94.0 +/- 7.7 mmHg), and this reduction was maintained until the end of the study (142.0 +/- 14.0/90.0 +/- 8.2 mmHg). At the 6th month and in comparison with placebo, a significant (p less than 0.01) reduction of left ventricular mass (LVM) and of LVMI was observed (LVM: from 295.9 +/- 113.8 to 221.5 +/- 66.1 g; LVMI: from 158.1 +/- 39.0 to 126.2 +/- 35.8 g/m2. In conclusion, our results confirm the good antihypertensive efficacy of the fixed combination slow-release oxprenolol and chlorthalidone and show that the study medication is able to induce a regression of left ventricular hypertrophy, in hypertensive patients.

Adult↗

PubMed1988

Bronchoneutral effects in hypertensive asthmatics--celiprolol versus chlorthalidone.

The actions of celiprolol and chlorthalidone on lung function were studied in a randomized double-blind study of 30 patients. At the end of a 4-week placebo run-in period each patient had a supine diastolic blood pressure between 90 and 115 mmHg, and a forced expiratory volume at the first second of expiration (FEV1) 50-80% of the predicted value in patients with bronchial asthma, and between 40% and 70% of the predicted value in patients with chronic airways obstruction. The active treatment period lasted 12 weeks during which patients received either celiprolol, 200-600 mg daily, or chlorthalidone 12.5-37.5 mg daily. Lung function, blood pressure and heart rate were measured and assessed every 2 weeks during active treatment. Systolic and diastolic blood pressures were reduced during treatment with both drugs, but FEV1, forced vital capacity and forced expiratory volume at 25-75% of vital capacity were not significantly altered. These results suggest that celiprolol does not adversely affect pulmonary function in hypertensive patients who also have chronic bronchial obstruction.

Antihypertensive Agents↗

PubMed1985

Double-blind crossover study of fenquizone compared to chlorthalidone in essential hypertension.

The clinical efficacy and tolerability of fenquizone (10 mg), a thiazide-like diuretic, were studied in comparison with chlorthalidone (25 mg) in 20 hypertensive out-patients during a four-month treatment course. Both drugs were very active in reducing hypertension. Fenquizone proved to be more active on systolic blood pressure, while there were no differences between groups regarding diastolic blood pressure. Chlorthalidone induced a more significant loss of plasma K+ than fenquizone. Fenquizone showed also a significant decrease of symptoms (headache, dizziness) due to hypertension. No undesirable side effects were observed.

Adult↗

PubMed1984

Effects of moderate salt restriction in hypertensive patients treated with oxprenolol or chlorthalidone.

Ninety-five hypertensive out-patients, whose lying diastolic blood pressure was still greater than or equal to 95 mm Hg after a 4-week treatment with oxprenolol slow release 160 mg/day or chlorthalidone 25 mg/day, restricted their daily sodium intake for a 4-week period, while continuing to receive the previous pharmacological therapy. The dietary intervention, appositely formulated to moderately restrict sodium intake, resulted in a high patient compliance as assessed by the significant (p less than 0.01) reduction in the 24-hour urinary sodium excretion. At the end of the 4-week dietary period, a significant (p less than 0.01) decrease in lying and standing systolic and diastolic blood pressure was observed in both the oxprenolol and chlorthalidone treated groups. These results suggest that a moderate reduction in sodium intake, obtained from a low sodium diet characterized by high patient compliance and easily followed in everyday life, is effective in lowering blood pressure in hypertensive patients who don't respond satisfactorily to pharmacological therapy alone.

Adult↗

PubMed1983

Management of essential hypertension with oxprenolol and chlorthalidone in a fixed combination.

A study was carried out in 40 patients with mild to moderate essential hypertension. The treatment administered was a fixed drug combination of oxprenolol (160 mg) and chlorthalidone (20 mg) in a single morning dose for 16 weeks. As a result, resting and standing blood pressure decreased significantly) (p less than 0.001). As regards clinical tolerance, this was adequate although treatment had to be discontinued in three patients. The minor side effects observed in other patients did not necessitate withdrawal of therapy. Only minor changes of the biochemical parameters were observed. It may be concluded that some patients with mild to moderate hypertension can be adequately treated with a single daily dose of a fixed drug combination of oxprenolol and chlorthalidone.

Adult↗

PubMed1982

Low doses v standard dose of reserpine. A randomized, double-blind, multiclinic trial in patients taking chlorthalidone.

Reserpine in different doses was assigned in random, double-blind fashion to 329 patients with mild to moderate hypertension who had not achieved normotension with chlorthalidone therapy alone. The additional reduction of BP averaged 11.0/10.4 mm Hg with chlorthalidone, 50 mg, plus reserpine, 0.25 mg (C 50+R 0.25); 9.5/9.4 mm Hg with C 50+R 0.125; 6.4/8.5 mm Hg with C 50+R 0.05; and 9.9/9.6 mm Hg with C 25+R 0.125. The percentage of patients in whom control was achieved at diastolic BP less than 90 mm Hg and at least 5 mm Hg below baseline with either chorthalidone alone or with reserpine added was 65% with C 50+R 0.25, 69% with C 50+R 0.125, 58% with C 50+R 0.05, and 56% with C 25+R 0.125. Side effects of lethargy and impotence noted by patients with the 0.05-mg dose of reserpine were only one third of those noted with the 0.25-mg dose, although the incidence of other side effects did not differ. These results indicate that hypertension in many persons can be controlled by less than customary doses of reserpine in combination with a diuretic.

Blood Pressure↗

PubMed1981

Use of the the combination labetalol plus chlorthalidone in essential arterial hypertension therapy.

Eleven patients suffering from WHO stage II essential arterial hypertension were treated with the combination of labetalol plus chlorthalidone in the reciprocal ratio of 10:1 in the form of once-a-day administration in the morning. The dosage was individualized on the basis of hypotensive response and side effects until an acceptable blood pressure was achieved. The duration of the treatment was 45 days with blood pressure measurements after 7, 15, and 45 days. By the end of the first week of therapy significant reductions had already been obtained in systolic arterial pressure (down from 181 +/- 24 to 157 +/- 9 mmHg, P less than 0.01) and diastolic arterial pressure (down from 110 +/- 7 to 96 +/- 7 mmHg, P less than 0.01), reductions which were also maintained over time. The mean dosage at the time of the final measurement was 150 mg (136 mg labetalol and 14 mg chlorthalidone). In no case were orthostatic hypotension phenomena observed, and the side effects proved modest without requiring suspension of the therapy. Because of the simplification of the therapy, patient compliance was good.

Adult↗