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 .
Lower dose diuretic therapy in the treatment of patients with mild to moderate hypertension.
Indapamide ( Lozol ) , an indoline antihypertensive drug with diuretic and vasodilating activities , was evaluated in 195 patients with mild to moderate essential hypertension ( sitting DBP between 95 and 110 mmHg ) in a multicentre , r and omised , double-blind , parallel-group design trial . A four week single-blind placebo wash-out period was followed by an eight week double-blind period . Patients were r and omised to indapamide 1.25 mg/day or to placebo . The primary efficacy endpoint was the mean change in sitting DBP from baseline to week 8 . Ninety patients in the placebo group ( 93 % ) and 82 patients ( 84 % ) in the indapamide group completed the eight weeks of double-blind therapy . Indapamide produced a mean ( SE ) decrease in sitting DBP of 7.4 ( 0.63 ) mmHg ( from 100.1 to 92.8 mmHg ) compared with a decrease of 3.6 ( 0.75 ) mmHg ( from 99.6 to 95.8 mmHg ) produced by placebo ( p < 0.0001 ) . Indapamide and placebo also produced mean decreases in st and ing DBP of 6.8 ( 0.75 ) and 2.8 ( 0.77 ) mmHg , respectively ( p = 0.0002 ) , in sitting SBP of 11.1 ( 1.18 ) and 3.2 ( 1.35 ) mmHg , respectively ( p = 0.0001 ) and in st and ing SBP of 11.4 ( 1.29 ) and 4.0 ( 1.43 ) mmHg , respectively ( P = 0.0002 ) . Reduction in BP of > or = 10 mmHg or to a DBP of < or = 90 mmHg was more frequent ( P = 0.0005 ) among indapamide ( 46.6 % ) compared with placebo ( 23.7 % ) treated patients . During the eight week double-blind treatment period , incidence rates for all adverse experiences and for drug-related adverse experiences were similar between the two treatment groups . ( 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 .