Primary care nephrology and hypertension
A large randomized trial of combination therapy for hypertension in patients at high risk for cardiovascular complications found that in patients receiving an ACE inhibitor, cardiovascular event rates were lower with amlodipine compared with hydrochlorothiazide (HCTZ) . Given these results and earlier results showing that outcomes with chlorthalidone were at least as good as with amlodipine, we suggest that patients who are started on a thiazide diuretic for hypertension be treated with chlorthalidone rather than HCTZ.A meta-analysis involving 1193 patients undergoing surgery found that N-acetylcysteine, compared with placebo, failed to provide benefit in preventing acute kidney injury .
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