title: Hydrochlorothiazide hypertension treatment induced metabolic effects in type 2 diabetes: a meta-analysis of parallel-design RCTs.
abstract: Thiazide diuretics are still widely used as an initial therapy in essential hypertension, sometimes in both hypertensive and diabetic patients. However, the metabolic effects in type 2 diabetes treated with a thiazide diuretic have not been fully elucidated.
  
  
  
  Randomized controlled trials (RCTs) were identified from the electronic databases: the Cochrane Library, MEDLINE, and PubMed web of knowledge. The trials compared the metabolic effects of hydrochlorothiazide (HCTZ) versus no- HCTZ hypertension treatment in type 2 diabetes.
  
  
  
  A total of 368 papers showed a match, in the keyword search. Upon screening the title, reading the abstract and the entire article, 13 parallel-design RCTs, described in 7 reports, involving 720 patients, showed fasting glucose (FG) (SMD = 0.27, 95% CI 0.11-0.43) and HbA1c (SMD = 1.09, 95% CI 0.47-1.72)significantly increased in the patients treated with HCTZ groups and high-density lipoprotein-cholesterol (HDL-C) (SMD = -0.44, 95% CI -0.81- -0.08) decreased in the patients treated with low-dose HCTZ groups. Our study showed FG, HbA1c and HDL-C significantly affected in the patients treated with low-dose HCTZ groups.
  
  
  
  Our study showed FG and HbA1c increased in the patients treated with the low-dose HCTZ groups, and HDL-C decreased in the patients. While thiazide diuretics are still a recommended medication of hypertension therapy for type 2 diabetes, treatment with low-dose HCTZ should be attempted to evaluate the effectiveness and adverse metabolic effects.
authors.affiliation: Department of Pharmacy, Feng-Yuan Hospital, Ministry of Health Welfare, Taichung, Taiwan, R.O.C. ctku@ttpc.mohw.gov.tw.
authors.forename: J-J
authors.initials: JJ
authors.lastname: Lin
authors.forename: H-C
authors.initials: HC
authors.lastname: Chang
authors.forename: C-T
authors.initials: CT
authors.lastname: Ku
authors.forename: H-Y
authors.initials: HY
authors.lastname: Chen
mesh_terms: D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy*; D004232:Diuretics / Q000009:adverse effects / Q000627:therapeutic use; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D006801:Humans; D006852:Hydrochlorothiazide / Q000008:administration & dosage*; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D016032:Randomized Controlled Trials as Topic
chemical_list: D000959:Antihypertensive Agents; D004232:Diuretics; D006852:Hydrochlorothiazide