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 .
Effect of Spirapril and Hydrochlorothiazide on Platelet Function and Euglobulin Clot Lysis Time in Patients with Mild Hypertension
Thirteen patients with mild hypertension ( untreated diastolic blood pressure of 95 to 114 mmHg ) received , in r and om order , three successive treatments of four weeks with placebo , spirapril ( 6 mg daily ) , or hydrochlorothiazide ( HCT2 ) ( 24 mg daily ) . At the end of each treatment , blood sample s for assessment of platelet aggregation and platelet release of platelet factor 4 ( PF4 ) and for assessment of fibrinolysis , estimated by tissue plasminogen activator ( t-PA ) , plasminogen activator inhibitor-type 1 ( PAI-1 ) , and euglob ulin clot lysis time ( ECLT ) , were taken , first at rest , then immediately after five to ten minutes of vigorous exercise , and finally after the subsequent hour of recovery rest . Platelet aggregation induced in vitro by adrenaline significantly decreased during treatment with HCT2 , the threshold rising to 10 μM as compared with 1.0 with placebo ( P < 0.05 ) at rest , and the threshold for adenosine diphosphate ( ADP ) aggregation also rose , from 2 μM to 4 ( NS ) . The resting plasma PF4 value fell , although not significantly , during HCT2 treatment from the placebo value of 3.28 to 2.56 ng/mL. During spirapril treatment there was no change in the threshold of either adrenaline or ADP for aggregation of platelets sample d at rest , and the PF4 plasma levels showed no significant reductions at rest . However , during exercise PF4 showed an approximate doubling of the resting value irrespective of therapy . This exercise-induced increase in PF4 was significantly reduced by spirapril as compared with placebo ( P < 0.05 ) . ECLT and t-PA did not shift significantly from the placebo level during either therapy . PAI-1 did not change  during spirapril therapy , but during HCT2 treatment it fell , although not significantly , to 9.36 IU/mL from 15.91 with placebo ( NS ) . Spirapril and HCT2 did not produce any unwanted side effect on platelet function or fibrinolysis . HCT2 seems to decrease platelet activity at rest , whereas spirapril seems to some extent to decrease platelet activity at exercise
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 .