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Health & Medicine for Senior Citizens

Diuretic for Hypertension Significantly Extends Life Expectancy 20 Years Later for Seniors

Chlorthalidone (brand name, Thalitone) helps senior citizens avoid cardiovascular death for years

Dec. 20, 2011 – A new study shows that treating senior citizen systolic hypertension patients with a diuretic has a long-lasting benefit that 20 years later appears to significantly prolong life free from cardiovascular death for these patients – adding one day for every month of treatment.

These patients with systolic hypertension who were treated with the diuretic chlorthalidone (brand name, Thalitone - read more below news report) for 4.5 years as part of a clinical trial had a significantly lower rate of death and a gain in life expectancy, compared to patients who received placebo, according to a study in the December 21 issue of the Journal of the American Medical Association (JAMA).

 

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"Antihypertensive drug therapy has been shown to decrease nonfatal and fatal cardiovascular events in controlled clinical trials and meta-analyses. However, long-term data on gain in life expectancy are not available," according to background information in the article.

John B. Kostis, M.D., of the UMDNJ-Robert Wood Johnson Medical School, New Brunswick, N.J., and colleagues conducted a study to examine the effect of blood pressure (BP) lowering on long-term outcomes such as life expectancy.

The researchers obtained long-term mortality data for participants in the Systolic Hypertension in the Elderly Program (SHEP) trial, which was a randomized, placebo-controlled, clinical trial. It was designed to assess the effect of antihypertensive drug treatment (chlorthalidone) in reducing the risk of stroke in patients with isolated systolic hypertension.

Recruitment for SHEP was between March 1985 and January 1988. After the end of a 4.5-year randomized phase of the SHEP trial, all participants were advised to receive active therapy.

The time interval between the beginning of recruitment and the ascertainment of death (December 2006) was approximately 22 years (21 years 10 months).

Of the 4,736 participants enrolled in the SHEP trial, 2,365 (49.9 percent) were randomized to active treatment therapy and 2,371 (50.1 percent) were randomized to placebo.

The average age of participants was 72 years, 57 percent were women, and 14 percent were black.

At the end of follow-up, 2,851 of the 4,736 randomized patients (60.2 percent) had died. There were 1,416 deaths (59.9 percent) in the active treatment group and 1,435 deaths (60.5 percent) in the placebo group.

The researchers found that both life expectancy and time to the 70th percentile survival at the end of follow-up were longer for the SHEP participants who were in the active group compared with those in the placebo group.

Life expectancy gain at 22 years was 158 days for cardiovascular death and 105 days for death from all causes.

The gain in life expectancy free from cardiovascular death corresponds with 1 day (0.89 days) gained per month of treatment. For all-cause mortality, the gain in life expectancy from 1 month of antihypertensive drug treatment was estimated at a half day (0.59 days).

The authors also found that the active treatment group was associated with higher survival free from cardiovascular death compared with the placebo group (669 deaths [28.3 percent] vs. 735 deaths [31 percent], respectively).

"Reporting that each month of antihypertensive therapy was associated with 1 day prolongation of life expectancy free from cardiovascular death is a strong message that may result in increased patient adherence to drug therapy and decrease the degree of therapeutic inertia by health care providers," the authors write.


About Chlorthalidone(klor thal' i done) (Brand name, Thalitone)

Why is this medication prescribed?

Chlorthalidone, a 'water pill,' is used to treat high blood pressure and fluid retention caused by various conditions, including heart disease. It causes the kidneys to get rid of unneeded water and salt from the body into the urine.

This medicine is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

How should this medicine be used?

Chlorthalidone comes as a tablet to take by mouth. It usually is taken once a day or every other day after a meal, preferably breakfast. It is best to take this medicine in the morning to avoid going to the bathroom during the night. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take chlorthalidone exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Chlorthalidone controls high blood pressure but does not cure it. Continue to take chlorthalidone even if you feel well. Do not stop taking chlorthalidone without talking to your doctor.

Other uses for this medicine

Chlorthalidone may also be used to treat patients with diabetes insipidus and certain electrolyte disturbances and to prevent kidney stones in patients with high levels of calcium in their blood. Talk to your doctor about the possible risks of using this medicine for your condition.

Last Revision: August 1, 2010.

>> For more information and updates at PubMed

>> More on this drug at MedlinePlus

 

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