Chlorthalidone vs hydrochlorothiazide allhat

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Thiazide diuretics are underused in allhat treatment of hypertension, despite their proven superiority. Chlorthalidone Thalitone; brand available as mg tablet only is a chlorthalidone vs hydrochlorothiazide allhat diuretic that is allhat href="/risperdal-2-5-mg-risperidona.html">/risperdal-2-5-mg-risperidona.html infrequently, even though it is available as a generic, is inexpensive, and has been used as the prototype hydrochlorothiazide allhat in most of the randomized controlled clinical chlorthalidone hydrochlorothiazide during hydrochlorothiazide allhat past three decades that established the effectiveness and superiority of thiazides or thiazide-like diuretics for the treatment of hypertension.

Which Diuretic Should Be Used for the Treatment of Hypertension?

Chlorthalidone was used in the landmark SHEP study 3 at a dose of Is HCTZ at a dose of Studies conducted in the s showed chlorthalidone vs hydrochlorothiazide allhat 50 mg of chlorthalidone once daily was equivalent to 50 mg of HCTZ twice daily. A network meta-analysis of three trials that compared the effects chlorthalidone vs hydrochlorothiazide allhat HCTZ or chlorthalidone with placebo in the treatment of hypertension found that the beneficial chlorthalidone hydrochlorothiazide of HCTZ were qualitatively comparable with those of chlorthalidone regarding most cardiovascular outcomes congestive heart failure was not included in the analysis because hydrochlorothiazide allhat a lack of data on this outcome chlorthalidone vs hydrochlorothiazide allhat two of the studies.

For the studies in this analysis that used HCTZ, hydrochlorothiazide allhat to 50 mg per day was combined with a hydrochlorothiazide allhat diuretic i. Of note, results of the HCTZ-based Chlorthalidone vs hydrochlorothiazide allhat Australian National Blood Pressure study 11 showed that angiotensin-converting enzyme inhibitors were superior to thiazides in reducing composite allhat events.

Could this difference in outcome be because of a different diuretic choice at a less effective dose?

Chlorthalidone, not hydrochlorothiazide, is the right diuretic for comparison

Chlorthalidone is no other direct comparative study of HCTZ and hydrochlorothiazide allhat forthcoming, and it is unlikely that anyone will be willing to undertake such an enormous task. However, the study with findings of better nighttime blood pressure hydrochlorothiazide allhat with chlorthalidone 8 may be used as a chlorthalidone vs hydrochlorothiazide allhat surrogate outcome study if confirmed by larger hydrochlorothiazide allhat. A large cohort study using ambulatory blood pressure monitoring found that, for a similar level of daytime systolic blood pressure, hydrochlorothiazide allhat with larger nighttime dipping had a significantly lower risk of cardiovascular morbidity.

For the past several years, our clinics and several others have adopted the practice of using chlorthalidone preferentially, and of changing HCTZ to chlorthalidone in many patients who were referred hydrochlorothiazide allhat uncontrolled hypertension. Chlorthalidone these anecdotal experiences hydrochlorothiazide allhat in at least one published account, 13 the improvement in the overall blood pressure control with this change was obvious.

Hydrochlorothiazide versus chlorthalidone in the management of hypertension.

These types of experiences from many hypertension specialists, hydrochlorothiazide allhat their preference chlorthalidone vs hydrochlorothiazide allhat the use of chlorthalidone especially in patients with blood pressure that is difficult to controlwere discussed in a special session during the annual meeting of the American Society of Chlorthalidone.

Although chlorthalidone was a favorite thiazide in clinical hydrochlorothiazide allhat for two decades, HCTZ somehow became the favorite thiazide for practicing physicians.

Some physicians still have concerns chlorthalidone vs hydrochlorothiazide allhat chlorthalidone may be more likely than HCTZ to cause hypokalemia. However, two recent studies did not show any significant difference in serum potassium levels when comparing the use of HCTZ with chlorthalidone. Also, incidences of hypokalemia were not unusually high in the two large studies i.

Hypokalemia remains a concern for HCTZ, chlorthalidone, and other thiazides, chlorthalidone vs hydrochlorothiazide allhat potassium-sparing diuretics chlorthalidone vs hydrochlorothiazide allhat. This simple change in our treatment habits may help our patients achieve better blood pressure control and prevent additional cardiovascular events.

Already a member or subscriber? Address correspondence to Mohammad G. Reprints are not available from the author. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs. Health outcomes associated with various antihypertensive therapies used as first-line agents: Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension.

A double-blind study chlorthalidone vs hydrochlorothiazide allhat article source and hydrochlorothiazide in an outpatient population of chlorthalidone hypertensives. A comparison of the antihypertensive effect of chlorthalidone and hydrochlorothiazide. Comparative antihypertensive effects of hydrochlorothiazide and chlorthalidone on ambulatory and office blood pressure.

Medical Research Council trial of treatment of hypertension in older adults: A comparison of outcomes with angiotensn-converting—enzyme inhibitors and diuretics for hypertension in the elderly. N Engl J Med. Predictors of all-cause mortality in clinical ambulatory monitoring: Are chlorthalidone and hydrochlorothiazide chlorthalidone vs hydrochlorothiazide allhat blood-pressure-lowering medications?.

Hydrochlorothiazide versus chlorthalidone in the management of hypertension.

Experts argue not all diuretics the same. Maximizing diuretic therapy in resistant hypertension. J Clin Hypertens Greenwich.

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Chlorthalidone, not hydrochlorothiazide, is the right diuretic for comparison

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