We found no clinical ly meaningful blood pressure-lowering differences between different drugs within the loop diuretic class .
BACKGROUND Antihypertensive drugs from the thiazide diuretic drug class have been shown to reduce mortality and cardiovascular morbidity .
Loop diuretics are indicated and used to treat hypertension , but a systematic review of their blood pressure-lowering efficacy or effectiveness in terms of reducing cardiovascular mortality or morbidity from r and omized controlled trial ( RCT ) evidence has not been conducted .
OBJECTIVES To determine the dose-related decrease in systolic or diastolic blood pressure , or both , as well as adverse events leading to participant withdrawal and adverse biochemical effects ( serum potassium , uric acid , creatinine , glucose and lipids profile ) due to loop diuretics versus placebo control in the treatment of people with primary hypertension .
TORAFIC study protocol: torasemide prolonged release versus furosemide in patients with chronic heart failure
Loop diuretics , such as torasemide and furosemide , are important agents in the treatment of chronic heart failure . Beneficial effects of torasemide immediate-release formulation beyond diuresis have been documented as the ability of this compound to inhibit myocardial synthesis and deposition of collagen type I in patients with chronic heart failure . In addition , torasemide-treated patients , but not furosemide-treated patients , showed decreased serum concentrations of the C-terminal propeptide of procollagen type I , a biochemical marker of myocardial fibrosis . The aim of the TORAFIC study is to test the efficacy of torasemide prolonged-release formulation ( PR ) in reducing myocardial fibrosis in chronic heart failure in a large , r and omized clinical trial . Methods : This prospect i ve , Phase IV , r and omized , blinded end point , active-controlled clinical trial will r and omize 142 patients with chronic heart failure in New York Heart Association functional class II – IV to 8 months treatment with either torasemide-PR ( 10–40 mg daily ) or furosemide ( 40–160 mg daily ) . The primary objective is to test the hypothesis that torasemide-PR is superior to furosemide in reducing myocardial fibrosis . The primary outcome measure is the difference in the change of serum propeptide of procollagen type I concentration from the initial to the final visit between both study groups . Secondary outcome measures include all efficacy variables related to heart failure ( signs and symptoms , ECG , echocardiogram and serum levels of N-terminal brain natriuretic propeptide ) . Secondary safety variables are heart rate , blood pressure , laboratory data , adverse events , cardiovascular events ( hospital admission , emergency department visits ) and quality of life ( Minnesota question naire ) . Discussion : This trial will test whether torasemide-PR possesses antifibrotic properties , which may provide an additional benefit beyond diuresis in patients with chronic heart failure
We found no clinical ly meaningful blood pressure-lowering differences between different drugs within the loop diuretic class .
BACKGROUND Antihypertensive drugs from the thiazide diuretic drug class have been shown to reduce mortality and cardiovascular morbidity .
Loop diuretics are indicated and used to treat hypertension , but a systematic review of their blood pressure-lowering efficacy or effectiveness in terms of reducing cardiovascular mortality or morbidity from r and omized controlled trial ( RCT ) evidence has not been conducted .
OBJECTIVES To determine the dose-related decrease in systolic or diastolic blood pressure , or both , as well as adverse events leading to participant withdrawal and adverse biochemical effects ( serum potassium , uric acid , creatinine , glucose and lipids profile ) due to loop diuretics versus placebo control in the treatment of people with primary hypertension .