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 .
Arterial compliance and baroreceptor sensitivity after chronic treatment with indapamide.
Arterial compliance , assessed by the ratio of stroke volume to pulse pressure , and baroreceptor sensitivity ( Oxford method ) , were determined in ten patients with essential hypertension , treated with placebo or indapamide ( 2.5 mg/day ) , in a cross-over , single blind study . After three months of therapy , mean arterial pressure was significantly reduced from 127 + /- 10 to 118 + /- 9 mmHg , ( P less than 0.001 ) , as was total peripheral vascular resistance ( from 3017 + /- 561 to 2457 + /- 614 dyne/sec/cm-5/m2 , P less than 0.001 ) . Significant increases occurred in cardiac index ( 3.47 + /- 0.55 to 4.03 + /- 0.86 l/min/m2 , P less than 0.01 ) , baroreceptor sensitivity assessed with phenylephrine  ( from 11.69 + /- 7.9 to 15.0 + /- 9.1 msec/mmHg , P less than 0.01 ) or with nitroglycerine ( from 4.77 + /- 1.6 to 7.11 + /- 2.7 msec/mmHg , P less than 0.01 ) and arterial compliance ( from 1.27 + /- 0.42 to 1.55 + /- 0.57 , P less than 0.01 ) . A significant direct correlation was found between arterial compliance and baroreceptor sensitivity assessed during induced increase and reduction of BP , both during placebo ( r = 0.88 , P less than 0.001 and r = 0.77 , P less than 0.01 , respectively ) and during active therapy ( r = 0.94 , P less than 0.001 and r = 0.92 , P less than 0.001 , respectively ) . These results support the conclusion that chronic treatment with indapamide enhances arterial compliances and reduces the heart load and blood vessel stress . The same effect could explain the enhancement of baroreceptor sensitivity promoted by the drug
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 .