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 hydrochlorothiazide, enalapril, and propranolol on quality of life and cognitive and motor function in hypertensive patients.
The effect of hydrochlorothiazide , propranolol , and enalapril on cognitive and motor function and quality of life ( QOL ) in hypertensive patients was studied . Patients > or = 55 years of age with asymptomatic essential hypertension were included in a r and omized , double-blind , placebo-controlled , crossover study . Subjects discontinued their previous antihypertensive agents and started hydrochlorothiazide 25 mg , extended-release propranolol hydrochloride 120 mg , enalapril maleate 10 mg , or placebo . One capsule was taken for three days and then the dosage was doubled for the remainder of a four-week period . Subsequent crossover treatments were begun without a washout period . In each treatment phase , a battery of psychometric tests was used to assess cognitive and motor function and quality of life ; all tests but one were self-administered via computer terminal . Pulse rate and blood pressure were recorded , and compliance was monitored by capsule count . Sixteen of 30 patients interviewed completed the trials ; one additional patient was evaluated after receiving all treatments except hydrochlorothiazide . Mean + /- S.D. age of the subjects was 66 + /- 6.1 years ; 10 were black and 7 white ; 9 were men . Except for the hydrochlorothiazide group , blood pressure in the active treatment groups did not differ significantly from placebo ; hydrochlorothiazide significantly reduced systolic but not diastolic blood pressure compared with placebo . Compared with placebo , hydrochlorothiazide was associated with fewer incorrect responses in a test of complex reaction time and with greater discriminant reaction time response rates ; otherwise , no difference between groups was noted in cognitive or motor performance . There were no significant differences between active treatments and placebo on individual QOL measures . ( ABSTRACT TRUNCATED AT 250 WORDS
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 .