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 .
Dopamine beta-hydroxylase and plasma renin activity in patients with low-, normal-, and high-renin essential hypertension.
The relationship of serum dopamine-beta-hydroxylase ( DBH ) , plasma renin activity ( PRA ) and urinary catecholamines ( IU catechols ) in various forms of essential hypertension ( EHT ) ( low , normal and high renin ) was evaluated . Eighty-four predominantly white , young ( 37 + / 8 years ( SD ) ) , mildly hypertensive patients ( diastolic pressure 93 + /- 4 mm Hg ( SD ) ) continued their regular diet and received no medications . Thirteen patients had low-renin , 64 had normal-renin , and seven had high-renin EHT .  DBH , total IU catechols and urinary norepinephrine were not different between these renin subgroups . DBH was significantly lower in all hypertensives ( 55.6 + /- 36 IU ) and in the low-renin subgroup ( 46 + /- 30 IU ) compared with normal subjects ( 68 + /- 35 IU ) ( p less than 0.01 ) . However , the DBH range was so broad that an individual DBH value did not distinguish EHT from normals . After a baseline period , patients were r and omly assigned to receive chlorthali done 50 mg q.a.m . or placebo in a double-blind study . In the chlorthalidone group 1 month after therapy , the diastolic pressure decreased , PRA increased , and total IU catechols and urinary norepinephrine increased . Serum DBH did not change during diuretic therapy . A significant correlation could not be shown between pretreatment DBH and the changes in PRA and IU catechols before and after diuretics for all treated EHT patients . However , within the normal PRA EHT subgroup receiving chlorthalidone , the one-third of patients with lowest pretreatment DBH levels ( n = 10 ) were compared with the one-third of patients with the highest pretreatment DBH values ( n = 10 ) . The lower DBH patients showed significantly less change in PRA ( delta PRA = 2.9 + /- 1.8 ng/ml/hr ) compared with the higher DBH patients ( delta PRA = 8.2 + /- 1.6 ; P less than 0.05 ) . In some EHT patients , DBH levels may be related to PRA response to diuretic therapy
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 .