Page 7 - hypertension_newsletter4_Final

REFLECTIONS
Hypertension
Hypertension Global Newsletter #4 2023

The authors suggest that arterial stiffness, as measured by cfPWV, may be an emerging novel risk factor for the development
of hypertension, obesity, hyperinsulinemia, insulin resistance, T2DM, and possibly dyslipidaemia among apparently healthy Hypertension
adolescents, young adults, and middle-aged adults. Arterial stiffness may not only be considered as hypertension-induced target
organ damage or signs of early vascular ageing. Still, it may be clinically defined and treated as a potential cause of elevated BP/
hypertension and altered cardiometabolic functions in youths having no prior disease risks.

CLINICAL PEARLS FROM THE FACULTY

WATCH
PROF. LAURENT DISCUSS HIS
THOUGHTS ON THE SIGNIFICANCE
OF THIS REVIEW TO CLINICAL
PRACTICE.

CLICK HERE
FOR THE LINK TO FULL ARTICLE

TREATMENT

Chlorthalidone vs. hydrochlorothiazide for hypertension-cardiovascular events.

Ishani A, et al. N Engl J Med. 2022 Dec 29;387(26):2401-2410.

Thiazide and thiazide-like diuretics are considered first-line treatments for hypertension. Guidelines have preferentially recommended
chlorthalidone, although real-world data suggest that prescriptions for hydrochlorothiazide exceed those for chlorthalidone.

This multicentre, pragmatic, open-label, randomized trial aimed
to assess the efficacy and safety of chlorthalidone compared
with hydrochlorothiazide in US veterans with hypertension.
13,523 adults ≥65 years of age (97% men) with a recent SBP
of ≥120 mmHg (mean baseline SBP 139 mmHg) and an active
prescription for hydrochlorothiazide (25 or 50 mg per day) were
assigned to continue or switch to chlorthalidone (12.5 or 25
mg per day). The primary outcome was the first occurrence of
a composite endpoint of non-fatal CV events (MI, stroke HF
hospitalization, or urgent coronary revascularization for unstable
angina) or non-cancer-related death.

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