title: Hydrochlorothiazide vs. chlorthalidone as the optimal diuretic for the management of hypertension.
abstract: Even though hydrochlorothiazide (HCTZ) and chlorthalidone are frequently considered interchangeable antihypertensive agents, they appear to differ both in their blood pressure lowering efficacy and in their effects on the lipid profile and on serum potassium, uric acid and glucose levels. More importantly, in randomized controlled trials, chlorthalidone was equally or more effective than other antihypertensive agents in cardiovascular risk reduction whereas treatment with HCTZ yielded conflicting results. Although there are no randomized trials comparing the effects of these two agents on cardiovascular events, retrospective data from the Multiple Risk Factor Intervention Trial suggest that chlorthalidone might reduce cardiovascular morbidity more than HCTZ. However, current guidelines do not consistently recommend one or the other and it remains to be established which one is the diuretic of choice.
authors.affiliation: First Propedeutic Department of Internal Medicine, AHEPA Hospital, 1 Stilponos Kyriakidi street, 546 36 Thessaloniki, Greece. ktziomalos@yahoo.com
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Tziomalos
authors.forename: Vassilios G
authors.initials: VG
authors.lastname: Athyros
authors.forename: Dimitri P
authors.initials: DP
authors.lastname: Mikhailidis
authors.forename: Andasterios
authors.initials: A
authors.lastname: Karagiannis
mesh_terms: D000959:Antihypertensive Agents / Q000494:pharmacology / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D002318:Cardiovascular Diseases / Q000517:prevention & control; D002752:Chlorthalidone / Q000494:pharmacology / Q000627:therapeutic use*; D004232:Diuretics / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D006852:Hydrochlorothiazide / Q000494:pharmacology / Q000627:therapeutic use*; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D008055:Lipids / Q000097:blood; D017410:Practice Guidelines as Topic
chemical_list: D000959:Antihypertensive Agents; D004232:Diuretics; D008055:Lipids; D006852:Hydrochlorothiazide; D002752:Chlorthalidone