In general, chlorthalidone was more likely to be associated with hospitalization for. All individuals aged 66 years or older who were newly treated with chlorthalidone or hydrochlorothiazide and were not hospitalized for heart failure, stroke, or myocardial infarction in the prior year were eligible for inclusion. This is despite several clinical trials that have used and documented the benefits of chlorthalidone for hypertension management. Chlorthalidone is more potent and exhibits both a longer duration of action and elimination halflife compared to hydrochlorothiazide. However, greater nighttime blood pressure reduction, and alleged pleiotropic effects have renewed the interest in chlorthalidone. Comparing clinical effectiveness and drug toxicity with hydrochlorothiazide and chlorthalidone using two potency ratios in a managed care population. Diuretics are the second most commonly prescribed class of antihypertensive medication, and. A populationbased cohort study chlorthalidone versus hydrochlorothiazide view more view less. Electronic health records and claims data were used to identify patients. Chlorthalidone may be more potent than hydrochlorothiazide in lowering blood pressure, but it also may be.
In the united states, hydrochlorothiazide is used more often than chlorthalidone, but many clinical trials. Ctd is structurally and pharmacokinetically distinct from hctz with a much longer halflife 4060 h vs. Let your doctor know if you have a history of gout. Comments on medscape are moderated and should be professional in tone. From the division of clinical and administrative pharmacy, college of. Hydrochlorothiazide versus chlorthalidone hypertension. Chlorthalidone and hydrochlorothiazide basic youtube. Your doctor will follow you closely to change the dose to match your bodys needs. Although it generally is agreed that as a class, thiazidetype diuretics are effective in reducing blood pressure bp and preventing cardiovascular disease cvd in hypertensive persons. High blood pressure, edema and chronic heart failure. Chlorthalidone versus hydrochlorothiazide in hypertension treatment. We used advanced methods, sensitivity analyses, and diagnostics, but given the possibility of residual confounding and the limited length of observation periods, further study is warranted. Hydrochlorothiazide for treatment of hypertension karyn springer, md, utah valley family medicine residency.
There is no extensive research available to prove that one medication should be preferred over other. Chlorthalidone versus amlodipine for hypertension in kidney. Compare chlorthalidone vs hydrochlorothiazide comprehensive. Mean 24h sbp was significantly lower for the chlorthalidone group than for the hydrochlorothiazide group at week 4 125. Chlorthalidone lowers the risk of cardiovascular events about 18% more than hctz. We agree with the authors that conclusive evidence in the form of an outcome study will be critical to finally put to rest the questions concerning the efficacy of these medications, despite the many publications over the past several years that have supported the use of chlorthalidone over hydrochlorothiazide. Comparing clinical effectiveness and drug toxicity with. Compare hydrochlorothiazide vs chlorthalidone skip to.
Readers will summarize the similarities and differences between hydrochlorothiazide and chlorthalidone diuretics for hypertension. Jun 18, 20 chlorthalidone versus hydrochlorothiazide for the treatment of hypertension in older adults. The benefits of switching from hydrochlorothiazide to. Most major clinical trials used either hydrochlorothiazide hctz or chlorthalidone. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. A recent study showed an increased risk of adverse events with 29 chlorthalidone, including hyponatremia. Comparisons of hydrochlorothiazide with indapamide and. The shep study, allhat, and recent guidelines from the nice group in england have really made the point that chlorthalidone is a superior thiazidetype diuretic to hydrochlorothiazide.
A recent study showed an increased risk of adverse events with chlorthalidone, including hyponatremia. Chlorthalidone versus hydrochlorothiazide for hypertension. High blood pressure, chronic heart failure and heart failure. In this cohort of 125,000 individuals, persistence of thiazide use was higher for hctz than chlorthalidone 72. Hydrochlorothiazide, which is better for uses like. Chlorthalidone versus hydrochlorothiazide american journal of. Pdf even though hydrochlorothiazide hctz and chlorthalidone are. Hydrochlorothiazide hctz is one of the most commonly prescribed generic medications to lower blood pressure and protect people from these issues, but it turns out theres an alternative that might be more effectivechlorthalidone. These findings do not support current recommendations to prefer chlorthalidone vs. Chlorthalidone, not hydrochlorothiazide, is the right. The comparative effectiveness of hydrochlorothiazide and. Prescribing information chlorthalidone chlortalidone tablets bp 50 mg therapeutic classification diuretic antihypertensive actions and clinical pharmacology chlortalidone inhibits reabsorption of sodium and chloride in the distal renal tubule thus promoting water loss.
Chlorthalidone versus hydrochlorothiazide in hypertension. This is a pdf file of an unedited manuscript that has been accepted for publication. They have similar mechanism of action and side effect profile. Same benefit with equivalent doses of chlorthalidone and hctz. Chlorthalidone is a prescription drug used to treat high blood pressure hypertension. Although there are several thiazide diuretics currently available, hydrochlorothiazide hctz continues to be the most popular thiazide used for treating high blood pressure. This study compared the clinical effectiveness and drug toxicity of chlorthalidone and hydrochlorothiazide. These findings do not support current recommendations to prefer chlorthalidone vs hydrochlorothiazide for hypertension treatment in firsttime. Clinic and department of surgery, royal free campus, university. Studies have found that chlorthalidone provides greater blood pressure lowering effects over a 24hour period than hctz. Are chlorthalidone and hydrochlorothiazide equivalent blood. The authors aim to compare the efficacy of amlodipine or hydrochlorothiazide hctz with an arb. Patients treated with chlorthalidone were more likely. Chlortalidone, also known as chlorthalidone, is a diuretic medication used to treat high blood pressure, swelling including that due to heart failure, liver failure, and nephrotic syndrome, diabetes insipidus, and renal tubular acidosis.
Hydrochlorothiazide hctz has often been contrasted with chlorthalidone, but relatively little is known about hctz versus indapamide indap. Microzide hydrochlorothiazide hctz is a welltolerated water pill thats often the firstchoice treatment for mild high blood pressure. This is a randomized, doubleblind, crossover study to evaluate chlorthalidone and hydrochlorothiazide and their effects on endothelial function in hypertensive patients. Comparison of newonset gout in adults prescribed chlorthalidone vs. Chlorthalidone versus hydrochlorothiazide for the treatment of hypertension in older adults. Chlorthalidone vs chlorothiazide hypertension drugs. A populationbased cohort study chlorthalidone versus. Chlorthalidone fda prescribing information, side effects. This medicine is a strong fluidlowering drug diuretic. There are important differences between hydrochlorothiazide and chlorthalidone in pharmacology, potency, and frequency of met abolic side effects. Among the chlorthalidone group, 149 composite events were identified. In 9 post hoc analyses comparing patients initially prescribed 12.
States, but interest in chlorthalidone is increasing. Chlorthalidone versus hydrochlorothiazide article in the american journal of medicine 1278 may 2014 with 189 reads how we measure reads. Using national veterans administrative pharmacy data from 2003 to 2008, the authors performed a retrospective cohort study examining the effectiveness of chlorthalidone and hctz among new thiazide users. Mar 19, 20 each chlorthalidone recipient was matched to up to 2 hydrochlorothiazide recipients on the basis of age, sex, year of treatment initiation, and propensity score.
Chlorthalidone vs chlorothiazide hypertension drugs comparison. Chlorthalidone versus hydrochlorothiazide annals of. Chlorthalidone is indicated as adjunctive therapy in edema associated with congestive heart failure, hepatic cirrhosis, and corticosteroid and estrogen therapy. Thalitone chlorthalidone is a welltolerated water pill thats increasingly used to treat high blood pressure. Are chlorthalidone and hydrochlorothiazide equivalent. Pdf chlorthalidone versus hydrochlorothiazide researchgate. The use of thiazide diuretics for the treatment of hypertension is strongly encouraged by current guidelines. Prescribers need to be made aware of the potential for chlorthalidone for patients with hypertension.
Efficacy of lowdose chlorthalidone versus hydrochlorothiazide remains ambiguous. Comparison between baseline and wilcoxon signed rank test results. Following the initial visit, patients were switched from hctz to ctd at. Hello, thank you for trusting healthcaremagic both hydrochlorothiazide and chlorthalidone belong to similar class of medication. Although it generally is agreed that as a class, thiazidetype diuretics are effective in reducing blood pressure bp and preventing cardiovascular. Recent data indicate that calcineurin inhibitors activate the thiazidesensitive sodium chloride cotransporter, providing further rationale to test thiazides in this population. Key points chlorthalidone has a longer duration of action and a longer halflife than hydrochlorothiazide. Sometimes too much water and major elements potassium in the blood may be lost. Hctz and chlorthalidone were not directly compared in these rcts. Pdf on jun 18, 20, alberto donzelli and others published chlorthalidone versus hydrochlorothiazide find, read and. Possible side effects muscle weakness, dizziness, cramps, thirst, stomach pain, upset stomach, vomiting, diarrhea, loss of appetite, headache, hair loss.
Oct 15, 20 in this retrospective analysis, chlorthalidone and hctz produced the same clinical outcomes in older adults. Compare chlorthalidone vs metoprolol comprehensive. Thiazide diuretics are one of the preferred pharmacologic treatments for hypertension. If you have lupus, chlorthalidone can make your lupus. The authors summarize the literature comparing these two agents. If you use doses of chlorthalidone greater than 25 mg the benefit for bp reduction is limited. It is also used to reduce extra salt and water in the body caused by conditions such as heart failure, liver disease, and kidney disease. However, chlorthalidone was associated with higher risk for hypokalemia, hyponatremia, acute renal failure, chronic kidney disease, and type 2 diabetes. Ann intern med 20 mar 19 risk for death or adverse cardiovascular events appears to be similar, but electrolyte abnormalities are more likely with chlorthalidone. In high blood pressure it is a preferred initial treatment. Hydrochlorothiazide and chlorthalidone have been the 2 most commonly used diuretics in.
Trials sponsored by the national heart, lung, and blood institute used. The primary outcome was a composite of death or hospitalization for heart failure, stroke, or myocardial infarction. A very important difference is the extremely long halflife of 40 to 60 hours for chlorthalidone, in the other hand hydrochlorothiazide has a much shorter but wider variation in halflife, from 3 to hours. Hydrochlorothiazide and chlorthalidone have been the 2 most commonly used diuretics in major clinical trials. Thalitone chlorthalidone can increase the kidneys retention of uric acid, which can increase your risk of gouty attacks. Chlorthalidone versus hydrochlorothiazide for hypertension in. Hydrochlorothiazide hctz and chlorthalidone are both thiazide diuretics recommended as firstchoice options for treating high blood pressure because of their benefits on heart health and overall death rates. As a result, some experts have argued that clinicians should favor it over hydrochlorothiazide 8, whereas others have argued that the drugs are largely interchangeable 14. Ann intern med 20 mar 19 risk for death or adverse cardiovascular events appears to be similar, but electrolyte abnormalities are. If you are allergic to any drugs like this one, any other drugs, foods, or other substances.
Chlorthalidone versus hydrochlorothiazide for the treatment. Dec 12, 20 pharmacologic treatment of hypertension, including the use of thiazidetype diuretics, has had a major impact on reducing the risk of stroke, heart failure, myocardial infarction, and death in the population. Differences in chlorthalidones mechanism of action vs. Chlorthalidone has also been found useful in edema due to various forms of renal dysfunction, such as nephrotic syndrome, acute glomerulonephritis, and chronic renal failure. In terms of blood pressure lowering, both hctz and chlorthalidone appear to be very effective.
Chlorthalidone and hydrochlorothiazide are often considered as interchangeable. As a service to our customers we are providing this early version of the manuscript. If you have an allergy to chlorthalidone or any other part of chlorthalidone. Chlorthalidone is a very effective antihypertensive drug, but it has not been studied prospectively in kidney transplant recipients with hypertension.
More adverse events with chlorthalidone than hydrochlorothiazide. Hydrochlorothiazide is the more commonly prescribed thiazide diuretic, but chlorthalidone may have greater benefits. Hydrochlorothiazide vs chlorthalidone detailed answer. Electronic health records and claims data were used to identify patients initially prescrib. Cleveland clinic journal of medicine volume 82 number 8 august 2015 527 the thiazide diuretic hydrochlorothia zide and the thiazidelike diuretic chlortha. Thiazide and thiazidelike diuretics are widely used in the management of hypertension, but recently the equivalence of hydrochlorothiazide and chlorthalidone for blood pressure bp lowering and. Hydrochlorothiazide versus chlorthalidone in the management. However, we wish to highlight that chlorthalidone ctd is the evidencebased and recommended antihypertensive diuretic, and should replace hctz in the trial to effectively compare efficacy against the ccb amlodipine. Chlorthalidone versus amlodipine for hypertension in. The comparative effectiveness of hydrochlorothiazide and chlorthalidone in an observational cohort of veterans. Pharmacologic treatment of hypertension, including the use of thiazidetype diuretics, has had a major impact on reducing the risk of stroke, heart failure, myocardial infarction, and death in the population. Compare chlorthalidone vs metoprolol comprehensive analysis. Oct 14, 20 a very important difference is the extremely long halflife of 40 to 60 hours for chlorthalidone, in the other hand hydrochlorothiazide has a much shorter but wider variation in halflife, from 3 to hours. Comparison of cardiovascular and safety outcomes of.
Thiazide and thiazidelike diuretics are widely used in the management of hypertension, but recently the equivalence of hydrochlorothiazide and. Decreasing extra salt and water in the body helps to decrease swelling and. Background thiazide and thiazidelike diuretic agents are being increasingly used at lower doses. Indirect evidence suggests that chlorthalidone may be more effective than hydrochlorothiazide hctz, but direct comparisons are lacking. The target dose recommenda tions are hydrochlorothiazide 25 to 50 mg or chlorthalidone 12.
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