• Hiroshi Nakane, Masahiro Kamouchi, Jun Hata, Setsuro Ibayashi, Kenji Kusuda, Tsuyoshi Omae, Tetsuhiko Nagao, Tetsuro Ago, Takanari Kitazono, and EMINENT Study Investigators.
• Cerebrovascular and Neurology Center, Cerebrovascular Division, National Hospital Organization Fukuoka Higashi Medical Center, Japan.
• Intern. Med. 2015 Jan 1; 54 (6): 573577573-7.

ObjectiveThiazide diuretics are reported to have antioxidant effects and reduce pulse pressure (PP). The aim of this study was to elucidate whether hydrochlorothiazide additionally exerts such effects in stroke patients under treatment with losartan.MethodsThis study was an open-label, randomized, multicenter study. Patients with a history of chronic stroke and treatment with angiotensin receptor blockers or angiotensin-converting enzyme inhibitors for essential hypertension were enrolled. Fifty-five hypertensive patients were randomly assigned to two groups: those further treated with hydrochlorothiazide and those further treated with non-diuretic antihypertensive drugs.ResultsBoth groups showed a significant decrease in PP over six months (hydrochlorothiazide group: 67±12 mmHg to 58±12, p<0.001; non-diuretic group: 72±12 to 61±12, p<0.001), although no significant differences were observed between the two groups. The malondialdehyde-modified low-density lipoprotein levels did not change significantly after treatment in either group.ConclusionIn this study, hydrochlorothiazide treatment did not provide any additional benefits over non-diuretic antihypertensive drugs in terms of antioxidant effects or reducing PP.

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