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 .
Safety of losartan in hypertensive patients with thiazide-induced hyperuricemia.
BACKGROUND Losartan , an angiotensin II receptor antagonist , has been shown to decrease serum uric acid and to increase urinary excretion of uric acid . METHODS To determine if this effect can increase the risk of acute urate nephropathy , 63 hypertensive patients with thiazide-induced asymptomatic hyperuricemia ( serum uric acid 7.0 to 12.0 mg/dl ) were r and omized double-blind to losartan 50 mg every day ( q.d . ) , losartan 50 mg plus hydrochlorothiazide ( HCTZ ) 50 mg q.d . , HCTZ 50 mg q.d . , or placebo for three weeks . To potentiate the risk of crystal formation , patients received a 2 g/kg protein diet one day prior to each clinic visit on days 0 ( baseline ) , 1 , 7 , and 21 . RESULTS Adverse events typically associated with acute urate nephropathy , for example , flank pain , hematuria , or increased blood urea nitrogen/creatinine , were not reported . Uric acid excretion and urine pH increased four and six hours after losartan on day 1 compared with day 0 . Dihydrogen urate , the primary risk factor for crystal formation , decreased at four and six hours on day 1 compared with day 0 associated with the concurrent rise in urine pH. Day 7 and 21 changes , compared with day 0 , in uric acid excretion rate , urine pH , and dihydrogen urate with losartan were comparable to day 1 results but were not statistically significant . Serum uric acid was significantly reduced after 21 days of therapy with losartan . CONCLUSION Losartan decreased serum uric acid and increased uric acid excretion without increasing urinary dihydrogen urate , the primary risk factor for acute urate nephropathy , during 21 days of dosing in hypertensive patients with thiazide-induced hyperuricemia
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 .