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Chlorthalidone and hydrochlorothiazide are diuretics used to lower blood pressure. Learn more about the primary differences between these two medications.
Chlortalidone is considered a first-line medication for treatment of high blood pressure. [2] Some recommend chlortalidone over hydrochlorothiazide. [1] [15] A meta-analysis of randomized controlled trials found that chlortalidone is more effective than hydrochlorothiazide for lowering blood pressure, while the two drugs have similar toxicity.
Hydrochlorothiazide appears be more effective than chlorthalidone in preventing heart attacks and strokes. [14] Hydrochlorothiazide is less potent but may be more effective than chlorthalidone in reducing blood pressure. [14] [15] More robust studies are required to confirm which drug is superior in reducing cardiovascular events. [16]
"Chlortalidone has a higher risk of side effects than hydrochlorothiazide." [1] Quote = However, chlorthalidone use is more frequently associated with adverse metabolic effects, particularly hypokalemia and hyponatremia, compared with HCTZ. Doc James (talk · contribs · email) 09:34, 2 November 2019 (UTC) Agreed. That ref is clear.
The thiazide-like diuretics (indapamide and chlorthalidone) reduce risk of major cardiovascular events and heart failure in hypertensive patients compared with hydrochlorothiazide with a comparable incidence of adverse events. [5] Both thiazide diuretics and thiazide-like diuretics are effective in reducing risk of stroke.
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Meanwhile, according to 2013 European Society of Cardiology (ESC) guidelines, a loop diuretic can only replace thiazide-type diuretics if there is renal impairment (Creatinine of more than 1.5 mg/dL or estimated glomerular filtration rate (eGFR) of less 30 mL/min/1.73 m 2 due to lack of long term cardiovascular outcome data and appropriate ...