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 .
Placebo-controlled comparison of captopril, metoprolol, and hydrochlorothiazide therapy in non-insulin-dependent diabetic patients with primary hypertension.
The antihypertensive effect of captopril , metoprolol , and hydrochlorothiazide was compared in 23 non-insulin-dependent ( NIDDM ) diabetic patients less than or equal to 75 years of age , with borderline to moderate primary hypertension . In a double blind , placebo-controlled cross-over trial the patients were treated with 25 to 50 mg captopril , 50 to 100 mg metoprolol , 12.5 to 25 mg hydrochlorothiazide , and placebo , each given twice daily for 8 weeks . Antidiabetic treatment remained unchanged during the study . After receiving placebo for a 4 week run-in period , arterial blood pressure was 168/101 + /- 93/10 ( mean + /- SEM ) mm Hg . Diastolic blood pressure was lowered significantly during all active treatment periods compared to the placebo value of 97 + /- 2 mm Hg : captopril , 92 + /- 1 mm Hg ; metoprolol , 90 + /- 1 mm Hg ; hydrochlorothiazide , 91 + /- 1 mm Hg . Metabolic variables were not significantly altered by captopril and metoprolol , while hydrochlorothiazide treatment increased hemoglobin A1c from 7.5 + /- 0.3 to 8.2 + /- 0.4 % ( P less than .001 ) , decreased high-density lipoprotein-cholesterol from 1.19 + /- 0.08 to 1.10 + /- 0.06 mmol/L ( P less than .05 ) . Glomerular filtration rate , urinary albumin excretion , orthostatic blood pressure response , and digital systolic blood pressure in the lower limb remained unchanged during the active treatment periods . The frequency of subjective adverse effects was acceptable during active treatment and not significantly different compared to placebo . We conclude that antihypertensive treatment for 8 weeks with captopril or metoprolol in NIDDM patients is well-tolerated and causes no deterioration in metabolic control and kidney function , while hydrochlorothiazide causes a slight deterioration in glycemic control and lipid profile
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 .