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Prevention of hypertension in patients with pre-hypertension: protocol for the PREVER-prevention trial

Flávio D Fuchs1, Sandra C Fuchs, Leila B Moreira

  • 1Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. ffuchs@hcpa.ufrgs.br

Trials
|March 8, 2011
PubMed

Insights

This study investigated if low-dose diuretics can prevent hypertension and cardiovascular events in pre-hypertensive individuals. Early use of blood pressure-lowering drugs may be a key public health strategy.

Area of Science:

  • Cardiology
  • Public Health
  • Pharmacology

Background:

  • Pre-hypertension increases cardiovascular risk and often progresses to hypertension.
  • Non-drug interventions for hypertension prevention have shown limited effectiveness.
  • Blood pressure-lowering agents can reduce cardiovascular events in high-risk patients and prevent hypertension.

Purpose of the Study:

  • To evaluate the efficacy, safety, and feasibility of a population-based intervention to prevent hypertension incidence.
  • To assess the prevention of target-organ damage in individuals with pre-hypertension.
  • To investigate the role of early pharmacological intervention in cardiovascular health.

Main Methods:

  • A randomized, double-blind, placebo-controlled trial (PREVER-prevention) involving 1250 participants aged 30-70 with pre-hypertension.
  • Intervention arms: chlorthalidone 12.5 mg plus amiloride 2.5 mg versus identical placebo.
  • Primary outcomes: hypertension incidence, adverse events, microalbuminuria, and left ventricular hypertrophy. Secondary outcomes: fatal/non-fatal cardiovascular events.

Main Results:

  • The study is ongoing; results are pending.
  • The trial is designed to detect a 40% reduction in hypertension incidence.
  • Sample size: 625 participants per group, powered for 85% with P alpha of 5%.

Conclusions:

  • Early use of diuretics may prevent hypertension and cardiovascular events in pre-hypertensive individuals.
  • This intervention, if proven effective and safe, could form the basis of a public health program in Brazil.
  • Pharmacological prevention of hypertension is a potential strategy for reducing cardiovascular disease burden.
Abstract

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