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In the April issue of Prescrire International - Hydrochlorothiazide in hypertension: an acceptable first choice

FREE DOWNLOAD In countries where it is available, chlorthalidone is the first-choice thiazide diuretic. In France, where there is no available medicinal product containing chlorthalidone alone, the first-line thiazide diuretic is hydrochlorothiazide. How do these two drugs compare?
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Summary

  • A pharmacoepidemiological study of about 700 000 hypertensive patients exposed to either chlorthalidone or hydrochlorothiazide did not show any significant difference in the incidence of cardiovascular events and mortality between these two groups of patients.
     
  • In the absence of a direct comparison with a higher level of evidence, these data support the pragmatic choice of hydrochlorothiazide as the first-line thiazide diuretic for most hypertensive patients in countries where chlorthalidone is not available, especially since this drug appears to cause fewer electrolyte abnormalities and renal adverse effects than chlorthalidone.

©Prescrire 1 April 2021

Source: "Hydrochlorothiazide in hypertension. An acceptable first choice" Prescrire International 2021; 30 (225): 107. Free.

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See also:

"Treating essential hypertension.
The first choice is usually
a thiazide diuretic"
Prescrire International 2014 ;
23 (152) : 215-220.
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