title: Evidence-based diuretics: focus on chlorthalidone and indapamide.
abstract: Thiazide and thiazide-like diuretics are cornerstone treatments for hypertension. However, unlike chlorthalidone (CTD) and indapamide (IDP), hydrochlorothiazide (HCTZ) lacks evidence for reducing morbidity and mortality as monotherapy compared with placebo or control. Despite this fact, HCTZ is prescribed much more frequently than CTD or IDP. We believe that all hypertension guidelines should follow the National Institute for Health and Excellence (NICE) and make IDP and CTD first choice 'thiazide-like diuretics.' This article will focus on the available evidence pertaining to HCTZ versus CTD and IDP. We will review the pharmacological differences between these three diuretics, as well as the clinical trial data and important side effects.
authors.affiliation: Mid America Heart Institute at Saint Luke's Hospital, Kansas City, MO, USA.
authors.forename: James J
authors.initials: JJ
authors.lastname: DiNicolantonio
authors.forename: Jaikrit
authors.initials: J
authors.lastname: Bhutani
authors.forename: Carl J
authors.initials: CJ
authors.lastname: Lavie
authors.forename: James H
authors.initials: JH
authors.lastname: O'Keefe
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use*; D002752:Chlorthalidone / Q000627:therapeutic use*; D004232:Diuretics / Q000627:therapeutic use*; D006801:Humans; D006852:Hydrochlorothiazide / Q000627:therapeutic use*; D006973:Hypertension / Q000188:drug therapy*; D007190:Indapamide / Q000627:therapeutic use*
chemical_list: D000959:Antihypertensive Agents; D004232:Diuretics; D006852:Hydrochlorothiazide; D007190:Indapamide; D002752:Chlorthalidone
keywords: chlorthalidone; hydrochlorothiazide; hypertension; indapamide; thiazide