Please use this identifier to cite or link to this item: http://repositorio.unicamp.br/jspui/handle/REPOSIP/542
Type: Artigo de periódico
Title: A comparison between diuretics and angiotensin-receptor blocker agents in patients with stage I hypertension (PREVER-treatment trial): study protocol for a randomized double-blind controlled trial
Author: FUCHS, Flavio D.
FUCHS, Sandra C.
MOREIRA, Leila B.
GUS, Miguel
NOBREGA, Antonio C.
POLI-DE-FIGUEIREDO, Carlos E.
MION, Decio
BORTOLOTTO, Luiz
CONSOLIM-COLOMBO, Fernanda
NOBRE, Fernando
COELHO, Eduardo Barbosa
VILELA-MARTIN, Jose F.
MORENO JR., Heitor
CESARINO, Evandro Jose
FRANCO, Roberto
BRANDAO, Andrea Araujo
SOUSA, Marcos R. de
RIBEIRO, Antonio Luiz Pinho
JARDIM, Paulo Cesar
AFIUNE NETO, Abrahao
SCALA, Luiz Cesar N.
MOTA, Marco
CHAVES, Hilton
ALVES, Joao Guilherme
SOBRAL FILHO, Dario C.
SILVA, Ricardo Pereira e
FIGUEIREDO NETO, Jose A.
IRIGOYEN, Maria Claudia
CASTRO, Iran
STEFFENS, Andre Avelino
SCHLATTER, Rosane
MELLO, Renato Bandeira de
MOSELE, Francisca
GHIZZONI, Flavia
BERWANGER, Otavio
Abstract: Background: Cardiovascular disease is the leading cause of death in Brazil, and hypertension is its major risk factor. The benefit of its drug treatment to prevent major cardiovascular events was consistently demonstrated. Angiotensin-receptor blockers (ARB) have been the preferential drugs in the management of hypertension worldwide, despite the absence of any consistent evidence of advantage over older agents, and the concern that they may be associated with lower renal protection and risk for cancer. Diuretics are as efficacious as other agents, are well tolerated, have longer duration of action and low cost, but have been scarcely compared with ARBs. A study comparing diuretic and ARB is therefore warranted. Methods/design: This is a randomized, double-blind, clinical trial, comparing the association of chlorthalidone and amiloride with losartan as first drug option in patients aged 30 to 70 years, with stage I hypertension. The primary outcomes will be variation of blood pressure by time, adverse events and development or worsening of microalbuminuria and of left ventricular hypertrophy in the EKG. The secondary outcomes will be fatal or non-fatal cardiovascular events: myocardial infarction, stroke, heart failure, evidence of new subclinical atherosclerosis and sudden death. The study will last 18 months. The sample size will be of 1200 participants for group in order to confer enough power to test for all primary outcomes. The project was approved by the Ethics committee of each participating institution. Discussion: The putative pleiotropic effects of ARB agents, particularly renal protection, have been disputed, and they have been scarcely compared with diuretics in large clinical trials, despite that they have been at least as efficacious as newer agents in managing hypertension. Even if the null hypothesis is not rejected, the information will be useful for health care policy to treat hypertension in Brazil.
Country: Inglaterra
Editor: BIOMED CENTRAL LTD
Rights: fechado
Identifier DOI: 10.1186/1745-6215-12-53
Address: http://dx.doi.org/10.1186/1745-6215-12-53
http://apps.isiknowledge.com/InboundService.do?Func=Frame&product=WOS&action=retrieve&SrcApp=EndNote&UT=000288423900001&Init=Yes&SrcAuth=ResearchSoft&mode=FullRecord
Date Issue: 2011
Appears in Collections:FCM - Artigos e Outros Documentos

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