HOUSTON, Tex -- November 11, 2008 -- Chlorthalidone is particularly effective at reducing the risk of heart failure in patients with left ventricular ejection fraction, according to a study published in the November 10 online issue of Circulation: Journal of the American Heart Association.
"We showed that a diuretic was as good as or better than other classes of medication for high blood pressure in reducing the occurrence of heart failure in people with a wide range of left ventricular ejection fraction," says lead author Barry Davis, MD, University of Texas School of Public Health, Houston, Texas.
The study involved 910 hypertensive adults who had been taking antihypertensive medications and who were subsequently diagnosed with heart failure in a hospital.
Participants were from the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT), which took place between 1994 and 2002.
Patients with an ejection fraction of 50% or more were defined as Heart Failure Preserved Ejection Fraction (HFPEF) (44%), and those with an ejection fraction of 49% or less as Heart Failure Reduced Ejection Fraction (HFREF) (56%).
Participants treated with chlorthalidone had reduced risk of HFPEF compared with those taking amlodipine, lisinopril, or doxazosin.
Chlorthalidone also reduced the risk of heart failure in people with reduced ejection fraction compared with amlodipine or doxazosin. Chlorthalidone was similar to lisinopril in preventing heart failure with reduced ejection fraction.
"On the basis of the data from many heart failure trials, [a combination of chlorthalidone and lisinopril] would be expected to be particularly effective in preventing heart failure in this group," the authors write.
"In both heart failure with preserved and reduced ejection fraction, the diuretic is helping to remove excess fluid, which can reduce both preload and after load and thus increase ejection fraction," says Dr. Davis.
SOURCE: University of Texas Health Science Center
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