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 .
Effects of atenolol and hydrochlorothiazide on blood pressure and plasma catecholamines in essential hypertension.
The antihypertensive effects of atenolol and hydrochlorothiazide were compared with placebo in a r and omized , double-blind crossover study , with the blood pressure responses related to sympathetic nervous system activity . Twelve patients with essential hypertension were given atenolol ( 100 mg ) , hydrochlorothiazide ( 50 mg ) , and placebo as single daily doses , each for 6 weeks . Mean supine , st and ing , and post-exercise blood pressures ( mm Hg ) on atenolol ( 155/94 , 152/95 , 177/93 , respectively ) and hydrochlorothiazide ( 154/99 , 150/103 , 172/96 ) were lower ( p less than 0.01 ) than corresponding placebo values ( 172/109 , 166/113 , 204/111 ) at 6 weeks . The role of the sympathetic nervous system in the antihypertensive actions of atenolol and hydrochlorothiazide was examined . The supine plasma norepinephrine on placebo was used as an index of sympathetic activity to categorize each patient 's " adrenergic status . " The six " hyperadrenergic " patients with high resting norepinephrine values ( mean , 302 pg/ml ) exhibited a greater ( p = 0.05 ) decrease in BP ( -30/-20 mm Hg ) on atenolol compared with the BP fall of -9/-11 mm Hg observed in the lower norepinephrine group ( mean , 211 pg/ml ) . Resting plasma norepinephrine values did not predict the BP fall on hydrochlorothiazide . The " adrenergic status " of each patient as measured by the plasma norepinephrine concentration tended to be relatively constant regardless of therapy or the state of activity . In this study , atenolol was an effective antihypertensive agent comparable to hydrochlorothiazide in potency . Adrenergic status tended to predict the BP response to atenolol and was a relatively constant feature of the patients in all treatment phases
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 .