Our library of drug research abstracts drawn from the medical literature is updated on a regular schedule, and you can be assured that new hctz research articles will be listed here shortly after becoming available to us.
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Medical research on hctz
Curr Med Res Opin. 2008 Aug 6;
Nash DT, Crikelair N, Zappe D
BACKGROUND: Most patients with hypertension will require combination therapy to achieve blood pressure (BP) goals, especially the elderly, obese, or those with stage 2 hypertension.OBJECTIVE: To assess BP response and time to achieve BP goals in a diverse population of hypertensive patients treated with hydrochlorothiazide, valsartan, or a combination.METHODS: For this secondary post-hoc analysis, data were pooled from two similar randomized, double-blind, 8-week trials that evaluated hydrochlorothiazide (12.5-25 mg) and valsartan (160 mg) monotherapies, their combination (160/12.5 mg), and placebo. Subgroups were defined by age, hypertension severity, and obesity. Adults with diastolic BP >/= 95 and
J Womens Health (Larchmt). 2008 Jul-Aug; 17(6): 931-8
Ofili EO, Cable G, Neutel JM, Saunders E
OBJECTIVE: This post hoc analysis of the Irbesartan/Hydrochlorothiazide Blood Pressure Reductions in Diverse Patient Populations (INCLUSIVE) trial evaluated the efficacy and safety of irbesartan/hydrochlorothiazide (HCTZ) in a diverse population of hypertensive women. METHODS: INCLUSIVE was a multicenter, prospective, open-label, single-arm trial. Adult subjects had uncontrolled systolic blood pressure (SBP 140-159 mm Hg; 130-159 mm Hg for those with type 2 diabetes mellitus [T2DM]) after > or =4 weeks of antihypertensive monotherapy. Treatment was sequential: placebo (4-5 weeks), HCTZ 12.5 mg (2 weeks), irbesartan/HCTZ 150/12.5 mg (8 weeks), and irbesartan/HCTZ 300/25 mg (8 weeks). Mean changes from baseline to treatment end in SBP and diastolic blood pressure (DBP), BP goal attainment, and safety were assessed. RESULTS: Treatment with irbesartan/HCTZ was associated with significant mean reductions in BP (intent-to-treat population, n = 370; SBP/DBP: -22.9/-10.3 +/- 14.7/8.8 mm Hg). Improvements in SBP were observed in all subgroups (p < 0.001): Caucasian (n = 207) -23.5 +/- 13.5 mm Hg; African American (n = 93) -21.0 +/- 17.2 mm Hg; Hispanics/Latino (n = 66) -23.6 +/- 14.3 mm Hg; age or =65 years (n = 89) -24.3 +/- 14.5 mm Hg; T2DM (n = 97) -19.0 +/- 15.1 mm Hg; and metabolic syndrome (n = 187) -22.1 +/- 14.6 mm Hg. Overall, 82% (95% confidence interval [CI] 78%-86%) of women achieved their SBP goal, 86% (95% CI 83%-90%) achieved their DBP goal, and 76% (95% CI 71%-80%) achieved their dual SBP/DBP goal. Treatments were well tolerated in all groups. CONCLUSIONS: Irbesartan/HCTZ treatment was effective and well tolerated in a diverse population of women whose BP was previously uncontrolled on monotherapy.
Retinal Phototoxicity Induced by Hydrochlorothiazide After Exposure to a UV Tanning Device.
Photochem Photobiol. 2008 Jul 30;
Costagliola C, Menzione M, Chiosi F, Romano MR, Della Corte M, Rinaldi M
UV radiation is known to cause acute and chronic eye and skin damage. The present case report describes the occurrence of hydrochlorothiazide-induced retinal phototoxicity immediately after exposure to UV light emanated from a sunbed in a 40-year-old myopic woman. During the tanning session she had always worn UV protective eyewear, except for a few minutes when she took the protective goggles off to put her spectacles on to locate and turn the timer switch off. At baseline her visual acuity was 10/25 in OD and 10/80 in OS. Fundus examination revealed the presence of retinal lesions in both eyes. More specific tests confirmed the presence of a phototoxic macular damage. Hydrochlorothiazide was discontinued, and she was recommended to wear UV filtering glasses. Over the follow-up period (12 months), a slow and progressive visual acuity recovery in both eyes occurred. At the last check the visual acuity improvement was of about 60% from baseline in both eyes. Fundus examination showed only a juxtafoveal flat pigmented scar of the retinal pigment epithelium in both eyes, milder in OD. The constant rise in the number of sunbed users makes the knowledge of UV-related side effects a problem that cannot be postponed further. Awareness of the general public about the harmful effects of UV exposure must represent one of the leading preventive health strategies. Therefore, a careful analysis of the medical history before the admission to a sunbed session throughout a questionnaire could represent an economic and effective measure to avoid further cases of a phototoxic macular damage in patients taking photosensitizing compounds.
Water Res. 2008 Jun 24;
Radjenović J, Petrović M, Ventura F, Barceló D
This paper investigates the removal of a broad range of pharmaceuticals during nanofiltration (NF) and reverse osmosis (RO) applied in a full-scale drinking water treatment plant (DWTP) using groundwater. Pharmaceutical residues detected in groundwater used as feed water in all five sampling campaigns were analgesics and anti-inflammatory drugs such as ketoprofen, diclofenac, acetaminophen and propyphenazone, beta-blockers sotalol and metoprolol, an antiepileptic drug carbamazepine, the antibiotic sulfamethoxazole, a lipid regulator gemfibrozil and a diuretic hydrochlorothiazide. The highest concentrations in groundwater were recorded for hydrochlorothiazide (58.6-2548ngL(-1)), ketoprofen (85%). Deteriorations in retentions on NF and RO membranes were observed for acetaminophen (44.8-73 %), gemfibrozil (50-70 %) and mefenamic acid (30-50%). Furthermore, since several pharmaceutical residues were detected in the brine stream of NF and RO processes at concentrations of several hundreds nanogram per litre, its disposal to a near-by river can represent a possible risk implication of this type of treatment.
J Int Med Res. 2008 Jul-Aug; 36(4): 630-7
Zhang S, Yu B, Li L, Du Z, Guan Z
In this randomized, double-blind study, 126 mild to moderate essential hypertensive patients from northern China were studied to determine the efficacy and safety of a combination therapy of valsartan and hydrochlorothiazide. Patients were randomized to the V80/H12.5 (80 mg valsartan/12.5 mg hydrochlorothiazide) group or the V80 (80 mg valsartan) group. Six weeks after treatment, the mean decrease from baseline in mean sitting systolic blood pressure (MSSBP) was significantly higher in the V80/H12.5 group than the V80 group, but there was no difference in the change of mean sitting diastolic blood pressure (MSDBP) in the two groups. Overall, 80.33% and 70.97% had a controlled response (normalized MSDBP), and 85.25% and 77.42% had a diastolic response (normalized MSDBP or > 10 mmHg reduction in MSDBP) in the V80/H12.5 and V80 groups, respectively (not significantly different). The incidence of adverse events was also similar between the two groups. The combination of 80 mg valsartan/12.5 mg hydrochlorothiazide was efficacious and well tolerated in mild and moderate essential hypertensive patients.
Acta Pol Pharm. 2008 May-Jun; 65(3): 283-7
Stolarczyk M, Apola A, Krzek J, Lech K
A quick and accurate method for determining triamterene and hydrochlorothiazide in complex drugs of diuretic activity by using first-derivative (D1) and second-derivative (D2) spectrophotometry was developed. The zero-crossing technique was employed in measurements, using D1 at lambda = 240.9 nm and D2 at lambda= 278.2 nm for determining triamterene and D1 at lambda = 255.7 nm and D2 at lambda = 283.2 nm for hydrochlorothiazide. The linear relationship between the values of derivatives and analyte concentrations are maintained for concentrations from 2.40 microg x mL(-1) to 12.00 microg x mL(-1) for triamterene and from 1.25 microg x mL(-1) to 6.25 microg x mL(-1) for hydrochlorothiazide. LOD for triamterene was 0.90 microg x mL(-1) or 1.02 microg x mL(-1), while LOQ was 2.73 microg x mL(-1) or 3.08 microg x mL(-1). The corresponding values for hydrochlorothiazide were: LOD 0.25 microg x mL(-1) or 0.17 microg x mL(-1) and LOQ 0.77 microg x mL(-1) or 0.51 microg x mL(-1) depending on the derivative used. The determination results of drug constituents are of high accuracy, percentage recovery ranging from 97.17% to 99.74% for triamterene and from 102.44% to 102.64% for hydrochlorothiazide, and good precision. The computed values of RSD are smaller than 2.73% for triamterene and below 1.63% for hydrochlorothiazide. Selectivity and sensitivity of the developed method are satisfactory.
Acta Pol Pharm. 2008 May-Jun; 65(3): 275-81
Stolarczyk M, Maślanka A, Krzek J, Milczarek J
A derivative spectrophotometry method was developed to determine enalapril, hydrochlorothiazide, candesartan and walsartan in complex antihypertensive drugs. The pharmaceutical preparations containing hydrochlorothiazide and one of the angiotensin convertase inhibitors were investigated. It was found that the developed method enables the constituents of the investigated drugs to be determined directly despite evident interference of the zero order absorption spectra. For determination of enalapril and hydrochlorothiazide as well as candesartan and hydrochlorothiazide the first derivative was used, while for walsartan and hydrochlorothiazide the second derivative was employed. The method was of high sensitivity; the LOD accuracy for enalapril was 2.81 microg x mL(-1), 0.56 microg x mL(-1) for candesartan, 4.02 microg x mL(-1) for walsartan and ranged from 0.31 microg x mL(-1) to 1.78 microgxmL(-1) for hydrochlorothiazide, depending on preparation under investigation. The recovery of individual constituents was within the limit of 100% +/- 5%, RSD varied from 1.11% to 2.94%, and the linearity range was from 4.1 microg x mL(-1) to 20.5 microg x mL(-1) for enalapril, from 6.45 microg x mL(-1) to 32.25 microg x mL(-1) for walsartan, from 2.36 microg x mL(-1) to 11.80 microg x mL(-1) for candesartan, and from 0.96 microg x mL(-1) to 26.00 microg x mL(-1) for hydrochlorothiazide.
J Pharm Biomed Anal. 2008 Jun 11;
Kumar V, Malik S, Singh S
A polypill for cardiovascular diseases (CVD) is under development. It is proposed to contain a combination of antithrombotic agent (aspirin), low-dose blood pressure lowering agents, i.e., angiotensin-converting enzyme inhibitor (lisinopril), one among a beta-blocker (atenolol) or diuretic (hydrochlorothiazide), and a statin (simvastatin/atorvastatin/pravatsatin, etc.). Due to the presence of multiple drugs in the same formulation, there is a strong likelihood of interaction among the drugs and/or their products. In a previous study, we observed formation of a number of interaction/degradation products from atenolol and lisinopril in the presence of aspirin. Accordingly, the purpose of this study was to characterize the resolved products using high resolution mass spectrometric and fragmentation analyses using a LC-MS/TOF system. Initially, studies were carried out on the drugs (atenolol, lisinopril and aspirin) to establish their complete fragmentation pattern. These studies were then extended to degraded samples to postulate the structures of interaction/degradation products. The characterized structures were justified through mechanistic explanations.
J Hum Hypertens. 2008 Jul 17;
Ekman M, Bienfait-Beuzon C, Jackson J
Irbesartan, an angiotensin-II inhibitor, has been shown to be an effective antihypertensive agent in clinical trials. The purpose of this study was to assess the cost-effectiveness of irbesartan in combination with hydrochlorothiazide (HCTZ) in Swedish health-care setting by predicting clinical events and life years based upon observed reductions in blood pressure in clinical trials. The cost-effectiveness of antihypertensive treatment with irbesartan compared with placebo and to other selected angiotensin-II inhibitors (losartan, valsartan, candesartan) in combination with HCTZ was estimated using a Markov model. The incidence of cardiovascular disease was obtained from the Swedish inpatient registry, whereas the risk reductions associated with antihypertensive therapy were taken from the medical literature. Costs for antihypertensive therapy and for treatment of cardiovascular events were included, and the health effects were measured in terms of quality-adjusted life years (QALYs). The study was conducted from a health-care payer perspective. For a 55-year-old male, irbesartan 150 mg/HCTZ 12.5 mg was a dominant strategy (better health effects at lower costs) when compared with losartan 50 mg/HCTZ 12.5 mg and valsartan 80 mg/HCTZ 12.5 mg, and the cost-effectiveness ratio compared with placebo was \[euro]3500 per QALY gained. In moderate-to-severe hypertension, irbesartan was cost-effective compared with losartan, whereas the results compared with candesartan were mixed. High-dose combination therapy of irbesartan was also found to be cost-effective compared with low-dose combination therapy. The results from the model indicate that irbesartan provides a cost-effective antihypertensive treatment strategy compared with both placebo, and to valsartan and losartan.Journal of Human Hypertension advance online publication, 17 July 2008; doi:10.1038/jhh.2008.76.
Hypertens Res. 2008 Apr; 31(4): 685-91
Xie HH, Zhang XF, Chen YY, Shen FM, Su DF
This study was designed to investigate the effects of a hydrochlorothiazide-nifedipine combination on blood pressure (BP), blood pressure variability (BPV), baroreflex sensitivity (BRS), and organ protection in spontaneously hypertensive rats (SHR). The doses used were 10 mg/kg/d for both hydrochlorothiazide and nifedipine, and 10+10 mg/kg/d for the combination of these two drugs. Drugs were mixed into rat chow at the aforementioned doses. SHR were treated for 4 months, and then BP was continuously recorded for 24 h. After the determination of BRS, rats were killed for organ-damage evaluation. It was found that long-term treatment with hydrochlorothiazide, nifedipine or both significantly decreased BP and BPV, enhanced BRS and conferred organ protection in SHR. The combination of hydrochlorothiazide and nifedipine had a significant synergistic effect on BPV reduction, BRS enhancement and organ protection in SHR, whereas no obvious synergism on BP reduction was found. Multiple-regression analysis showed that the decrease in left ventricular and aortic hypertrophy was most closely associated with the decrease in systolic BPV and the increase in BRS, and the amelioration of renal lesions was most closely associated with the increase in BRS. In conclusion, long-term treatment with a combination of hydrochlorothiazide and nifedipine yielded a significantly synergistic effect on BPV reduction, BRS restoration and organ protection in SHR. In addition to BP reduction, the decrease in BPV and the enhancement of BRS may have made important contributions to the observed organ protection.