Elliott has received research funding, honoraria, andor travel expenses from essentially every pharmaceutical company that makes, markets, or distributes antihypertensive drugs in the united states. Two ratios of potency for chlorthalidone vs hydrochlorothiazide. Hydrochlorothiazide chlorthalidone 152, 95% ci 150168 145, 95% ci systolic bp 8149 mm hg figure. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures. Hydrochlorothiazide vs chlorthalidone detailed answer. Chlorthalidone and hydrochlorothiazide are often considered as interchangeable. If you are allergic to any drugs like this one, any other drugs, foods, or other substances. The benefits of switching from hydrochlorothiazide to. A comparison of chlorthalidone and hydrochlorothiazide 11235 int j clin exp med 2017.
Studies have found that chlorthalidone provides greater blood pressure lowering effects over a 24hour period than hctz. Hydrochlorothiazide versus chlorthalidone hypertension. Although there are several thiazide diuretics currently available, hydrochlorothiazide hctz continues to be the most popular thiazide used for treating high blood pressure. Chlorthalidone versus hydrochlorothiazide for hypertension in. Same benefit with equivalent doses of chlorthalidone and hctz. However, greater nighttime blood pressure reduction, and alleged pleiotropic effects have renewed the interest in chlorthalidone. In high blood pressure it is a preferred initial treatment. 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.
Changes in median systolic blood pressure bp after 68 weeks in each of 19 patients on stable doses of hydrochlorothiazide who were changed to the same dose of chlorthalidone. However, indirect evidence summarized in a recent network metaanalysis 3 suggests that chlorthalidone may be more effective than hydrochlorothiazide in preventing cardiovascular events. Hydrochlorothiazide is the most commonly used agent, accounting for 95% of thiazide prescriptions in va patients compared with 2. 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. Hydrochlorothiazide and chlorthalidone have been the 2 most commonly used diuretics in major clinical trials. 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. But the new study found that patients taking chlorthalidone were three times more likely than those taking hydrochlorothiazide to have dangerously low levels of potassium and other electrolyte imbalances, as well as kidney problems. 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.
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. States, but interest in chlorthalidone is increasing. Chlorthalidone versus hydrochlorothiazide annals of. There are important differences between hydrochlorothiazide and chlorthalidone in pharmacology, potency, and frequency of met abolic side effects. Chlorthalidone may be more potent than hydrochlorothiazide in lowering blood pressure, but it also may be. Efficacy of lowdose chlorthalidone and hydrochlorothiazide.
Hydrochlorothiazide for hypertension in older adults original research chlorothiazide per day, we found that chlorthalidone was associated with an increased risk for hypokalemia for all 6 comparisons in which a statistically significant association was found. Hello, thank you for trusting healthcaremagic both hydrochlorothiazide and chlorthalidone belong to similar class of medication. Chlorthalidone shows a different safety profile compared with hydrochlorothiazide, with the following outcomes different after correction for multiple hypotheses. The remaining patients either withdrew consent 4 amlodipine, 1 chlorthalidone, 3 placebo, had a protocol violation 1 chlorthalidone, were lost to followup 1 chlorthalidone, or were withdrawn for another reason 1 placebo. Comparison of cardiovascular and safety outcomes of. Hydrochlorothiazide versus chlorthalidone in the management of hypertension. Key points chlorthalidone has a longer duration of action and a longer halflife than hydrochlorothiazide. Chlorthalidone compared with hydrochlorothiazide in reducing cardiovascular events. Data from the legend largescale evidence generation and evaluation in a network of databases observational comparative cohort study were used for the present analysis.
Pdf comparison of cardiovascular and safety outcomes of. There is no extensive research available to prove that one medication should be preferred over other. Hazard ratios hrs and forest plot of the 3 databases and the metaanalysis for chlorthalidone vs hydrochlorothiazide on the composite cardiovascular disease. Differences in chlorthalidones mechanism of action vs. Patients treated with chlorthalidone were more likely. Chlorthalidone versus hydrochlorothiazide for the treatment of hypertension in older adults. Is hydrochlorothiazide hctz as effective and safe compared to chlorthalidone as a firstline therapy for hypertension. Hydrochlorothiazide may be superior to chlorthalidone for treating uncomplicated hypertension because it is associated with less hypokalemia and hyponatremia, at least in commonly prescribed doses. 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.
Comparing clinical effectiveness and drug toxicity with. Hydrochlorothiazide, which is better for uses like. Chlorthalidone versus hydrochlorothiazide in hypertension. In this retrospective analysis, chlorthalidone and hctz produced the same clinical outcomes in older adults. A randomized, comparative study evaluating the efficacy and tolerability of losartanlow dose chlorthalidone 6. 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 versus hydrochlorothiazide for the treatment. Using chlorthalidone with other drugs that make you lightheaded can worsen this effect. Prescribers need to be made aware of the potential for chlorthalidone for patients with hypertension. Hydrochlorothiazide for treatment of hypertension karyn springer, md, utah valley family medicine residency, provo, utah help desk answers provides answers to questions. In a small, randomized, 8week crossover study comparing lowdose chlorthalidone to lowdose hydrochlorothiazide, chlorthalidone showed a decrease in nighttime blood pressure compared to hydrochlorothiazide.
A populationbased cohort study university of cincinnati. This is despite several clinical trials that have used and documented the benefits of chlorthalidone for hypertension management. Recommended diuretic drug chlorthalidone tied to harmful. 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. Five patients 3 amlodipine, 2 chlorthalidone discontinued due to adverse events. Thiazide diuretics are a mainstay for the treatment of hypertension. Chlorthalidone is a prescription drug used to treat high blood pressure hypertension. The use of thiazide diuretics for the treatment of hypertension is strongly encouraged by current guidelines. Hydrochlorothiazide is a diuretic and antihypertensive. They have similar mechanism of action and side effect profile. 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. 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. Capitals indicate lifethreatening, underlines indicate most frequent.
The authors summarize the literature comparing these two agents. Chlorthalidone, not hydrochlorothiazide, is the right. Six percent of patients taking chlorthalidone had low potassium, compared with 2% of those taking hydrochlorothiazide. Are chlorthalidone and hydrochlorothiazide equivalent blood. High blood pressure, edema and chronic heart failure. Thalitone chlorthalidone side effects, images, uses, dosage. However, chlorthalidone was associated with higher risk for hypokalemia, hyponatremia, acute renal failure, chronic kidney disease, and type 2 diabetes. The primary outcome was a composite of death or hospitalization for heart failure, stroke, or myocardial infarction. The authors aim to compare the efficacy of amlodipine or hydrochlorothiazide hctz with an arb. Feb 01, 2020 chlorthalidone is indicated as adjunctive therapy in edema associated with congestive heart failure, hepatic cirrhosis, and corticosteroid and estrogen therapy. More adverse events with chlorthalidone than hydrochlorothiazide. The target dose recommenda tions are hydrochlorothiazide 25 to 50 mg or chlorthalidone 12.
The rate remained the same even with lower doses of chlorthalidone, the researchers found. Amlodipine versus chlorthalidone versus placebo in the. How do hydrochlorothiazide and chlorthalidone compare for. Pdf on jun 18, 20, alberto donzelli and others published chlorthalidone versus hydrochlorothiazide find, read and cite all the research you need on researchgate. Oct 14, 20 chlorthalidone is superior to hydrochlorothiazide. Various compendia suggest that the 2 agents are equipotent 50 mg hctz is equivalent to 50 mg chlorthalidone. Thus, in the past 10 years, scholars have advocated for ctdn as an alter. 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. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems.
Thalitone chlorthalidone is a welltolerated water pill thats. Chlorthalidone fda prescribing information, side effects. 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. Treatment guidelines and compendia often consider these 2 drugs interchangeable agents within the class of thiazide or thiazidelike diuretics. Hydrochlorothiazide for hypertension in older adults. Hydrochlorothiazide versus chlorthalidone in the management. Thiazide diuretics are one of the preferred pharmacologic treatments for hypertension.
A recent study showed an increased risk of adverse events with chlorthalidone, including hyponatremia. Chlorthalidone versus hydrochlorothiazide as the preferred diuretic. Comparison of newonset gout in adults prescribed chlorthalidone vs. Hctz has a less than 24hour duration of action and. Jama intern med 2020 feb 17 a retrospective cohort study showed no major differences between the two drugs. Hydrochlorothiazide in hypertension disclosure information. Microzide hydrochlorothiazide hctz is a welltolerated water pill thats often the firstchoice treatment for mild high blood pressure. 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. 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. Longterm effects of chlorthalidone versus hydrochlorothiazide on electrocardiographic left ventricular hypertrophy in the multiple risk factor intervention trial michael e. Hydrochlorothiazide is the most commonly used thiazide diuretic in the united states, but interest in chlorthalidone is increasing. If you have an allergy to chlorthalidone or any other part of chlorthalidone. A recent study showed an increased risk of adverse events with.
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