Direct comparison of doses did not show evidence of dose dependence for blood pressure-lowering for any of the other thiazides for which RCT data were available : bendrofluazide , chlorthalidone , cyclopenthiazide , metolazone or indapamide .
This is based on an informal indirect comparison of results observed in other Cochrane review s on ACE inhibitors , ARBs and renin inhibitors compared with placebo , which used similar inclusion /exclusion criteria to the present review .Thiazides reduced potassium , increased uric acid and increased total cholesterol and triglycerides .
These effects were dose-related and were least for hydrochlorothiazide .
Chlorthalidone increased serum glucose but the evidence was unclear for other thiazides .
This systematic review shows that hydrochlorothiazide has a dose-related blood pressure-lowering effect .
Thiazides reduced potassium , increased uric acid and increased total cholesterol and triglycerides
BACKGROUND Hypertension is a modifiable cardiovascular risk factor .
Although it is established that low-dose thiazides reduce mortality as well as cardiovascular morbidity , the dose-related effect of thiazides in decreasing blood pressure has not been subject to a rigorous systematic review .
It is not known whether individual drugs within the thiazide diuretic class differ in their blood pressure-lowering effects and adverse effects .
OBJECTIVES To determine the dose-related decrease in systolic and /or diastolic blood pressure due to thiazide diuretics compared with placebo control in the treatment of patients with primary hypertension .
Secondary outcomes included the dose-related adverse events leading to patient withdrawal and adverse biochemical effects on serum potassium , uric acid , creatinine , glucose and lipids .
Indapamide SR versus candesartan and amlodipine in hypertension: the X-CELLENT Study.
BACKGROUND Reducing systolic blood pressure ( BP ) is of major benefit to patients with isolated systolic hypertension , but lowering normal diastolic BP may be harmful in terms of cardiovascular risk . Effects of different drugs on systolic BP , diastolic BP , and pulse pressure are therefore of interest . METHODS The NatriliX SR versus C and Esartan and amLodipine in the reduction of systoLic blood prEssure in hyperteNsive patienTs study ( X-CELLENT ) was a r and omized , double-blind , placebo-controlled study comparing the effects of three drugs on these BP components . Patients with systolic-diastolic or isolated systolic hypertension ( n = 1758 ) received indapamide ( 1.5 mg ) sustained release ( SR ) , c and esartan ( 8 mg ) , amlodipine ( 5 mg ) , or placebo once daily for 12 weeks . RESULTS Compared to placebo all active treatments reduced all BP components significantly ( P < .001 ) . For the patients with isolated systolic hypertension ( n = 388 ) , the three treatments significantly reduced systolic BP , but only indapamide SR did not change diastolic BP and thus reduced pulse pressure significantly relative to placebo ( P = .005 ) . In an ancillary study using ambulatory BP monitoring ( n = 576 ) , all three treatments significantly reduced BP components during 24 h relative to placebo . Changes in systolic BP and pulse pressure were similar with the three treatments , but the reduction in diastolic BP was significantly smaller , and therefore more favorable , with indapamide SR compared with c and esartan ( P = .039 ) . In patients with isolated systolic hypertension ( n = 106 ) , indapamide SR reduced 24-h systolic BP significantly more than amlodipine ( P = .037 ) , and only indapamide SR reduced 24-h pulse pressure significantly relative to placebo ( P = .03 ) . All three drugs were well tolerated . CONCLUSIONS This distinctive BP-lowering profile of indapamide SR seems highly beneficial when compared to the either of c and esartan or amlodipine
Direct comparison of doses did not show evidence of dose dependence for blood pressure-lowering for any of the other thiazides for which RCT data were available : bendrofluazide , chlorthalidone , cyclopenthiazide , metolazone or indapamide .
This is based on an informal indirect comparison of results observed in other Cochrane review s on ACE inhibitors , ARBs and renin inhibitors compared with placebo , which used similar inclusion /exclusion criteria to the present review .Thiazides reduced potassium , increased uric acid and increased total cholesterol and triglycerides .
These effects were dose-related and were least for hydrochlorothiazide .
Chlorthalidone increased serum glucose but the evidence was unclear for other thiazides .
This systematic review shows that hydrochlorothiazide has a dose-related blood pressure-lowering effect .
Thiazides reduced potassium , increased uric acid and increased total cholesterol and triglycerides
BACKGROUND Hypertension is a modifiable cardiovascular risk factor .
Although it is established that low-dose thiazides reduce mortality as well as cardiovascular morbidity , the dose-related effect of thiazides in decreasing blood pressure has not been subject to a rigorous systematic review .
It is not known whether individual drugs within the thiazide diuretic class differ in their blood pressure-lowering effects and adverse effects .
OBJECTIVES To determine the dose-related decrease in systolic and /or diastolic blood pressure due to thiazide diuretics compared with placebo control in the treatment of patients with primary hypertension .
Secondary outcomes included the dose-related adverse events leading to patient withdrawal and adverse biochemical effects on serum potassium , uric acid , creatinine , glucose and lipids .