Study shows effectiveness of low-cost medicine in treating high blood pressure in people with advanced kidney disease (Chlorthalidone safely lowers by 11 mmHg)

Medical XPress / Indiana University School of Medicine / New England Journal of Medicine ^ | Nov. 11, 2021 | Rajiv Agarwal et al

[ConservativeMind]

An all Indiana University School of Medicine team found that chlorthalidone was effective in lowering blood pressure in individuals with advanced kidney disease.

"Kidneys are key regulators of blood pressure. When an individual has chronic kidney disease, the kidneys are unable to control blood pressure," said Agarwal. "If a person suffers from chronic kidney disease and high blood pressure, it is more likely their kidney disease will advance even further and lead to other health issues such as heart failure."

Chlorthalidone was approved by the FDA in 1960 for treatment of high blood pressure or hypertension. However, it was largely believed to be ineffective in treating high blood pressure in people with advanced chronic kidney disease.

Results from the CLICK study showed chlorthalidone lowered blood pressure by a significant 11 mm Hg at 12 weeks as compared to 0.5 mm Hg reduction with placebo. There was a 50% reduction in albuminuria, a protein that appears in the urine of those suffering from kidney disease, which Agarwal says is remarkable and suggests that chlorthalidone has the potential to reduce kidney failure progression and hospitalizations for heart failure in these patients.

"These results show chlorthalidone is a low-cost solution for the treatment of hypertension in people with chronic kidney disease, " said Agarwal." These are people who are already taking a variety of medicines, so to have one that is cheap and effective is incredibly meaningful. However, the drug is potent, so the lowest therapeutic dose and careful monitoring is needed to avoid complications."

Agarwal's presentation from the American Society of Nephrology meeting is also available on YouTube:

[ConservativeMind]

Worth looking into if you have kidney issues.

[LittleBillyInfidel]

Thank you! Yeah, high BP really is a silent killer. Few or no symptoms while it destroys kidneys and blood vessels. Anyway, glad you posted!

[43north]

I tried ACE inhibitors, beta-blockers, and calcium channel blockers to try to control my BP. They worked but I did not tolerate the side effects. I tried hydrochlorothiazide w/o side effects but little effect on my BP. Switched to chlorthalidone and my BP came down and no side effects. It’s cheap too. Fortunately I do not have chronic kidney disease and because my BP is now under control I won’t.

[steve86]

But did not try ARBs?

I take an ARB and a calcium channel blocker.

[43north]

I developed bronchospasm from ACEI and did not want to try ARB’s because of their similarity. Bronchospasm is scary if you’ve never experienced it before.

[steve86]

I occasionally have very mild episodes myself; not significant enough to call them attacks and not quite to the scary level. But if the condition developed as a result of the ARBs it took many years. I think likely just a bronchitis-related thing. An OTC nasal steroid I keep for potential covid treatment does seem to stop it entirely.

[fella]

The DASH diet

[politicianslie]

for later