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 .
Antihypertensive efficacy and safety of losartan alone and in combination with hydrochlorothiazide in adult African Americans with mild to moderate hypertension.
BACKGROUND African Americans with hypertension , particularly those with more severe blood pressure elevations , are generally less responsive to monotherapy from any antihypertensive class . These patients usually require treatment with drugs from > or = 2 antihypertensive classes to achieve adequate blood pressure control . OBJECTIVE The purpose of this study was to assess the antihypertensive efficacy and safety of losartan alone and in combination with hydrochlorothiazide ( HCTZ ) in African American adults with mild to moderate hypertension . METHODS In this 12-week , multicenter , double-blind , r and omized , parallel-group , placebo-controlled study , African American patients were r and omized in a 3:3:1 ratio to I of 3 treatment groups : placebo , losartan monotherapy ( 50 to 150 mg ) , or losartan plus HCTZ ( 50/0 to 50/12.5 to 100/25 mg ) . Doses were titrated at weeks 4 and 8 if  sitting diastolic blood pressure ( SiDBP ) was > or = 90 mm Hg . Safety was assessed by determining the incidence of clinical and laboratory Adverse events and evaluating mean changes in pulse , body weight , electrocardiographic parameters , and laboratory test results . RESULTS A total of 440 patients were r and omized-188 to placebo , 193 to losartan monotherapy , and 59 to losartan/HCTZ ; 391 completed the study . At week 12 , the response rate with losartan monotherapy was 45.8 % , with a significant ( P < or = 0.01 ) lowering in mean SiDBP by 6.6 mm Hg compared with placebo ; the response rate with placebo was 27.2 % , with a mean SiDBP reduction of 3.9 mm Hg . Sitting systolic blood pressure ( SiSBP ) was significantly lowered with losartan monotherapy , by 6.4 mm Hg , compared with placebo ( reduction of 2.3 mm Hg ) . The response rate with losartan/ HCTZ was 62.7 % , with reductions in SiSBP and SiDBP of 16.8 mm Hg and 10.8 mm Hg , respectively ( P < or = 0.01 vs placebo and losartan monotherapy ) . The incidence of clinical adverse events was comparable in the 3 treatment groups . CONCLUSIONS The results of this study suggest that in African American patients , losartan monotherapy was significantly more effective than placebo in lowering SiSBP and SiDBP . Moreover , the losartan/ HCTZ combination regimen result ed in significant and clinical ly meaningful additional reductions in SiSBP and SiDBP compared with losartan monotherapy or placebo . Losartan monotherapy and the losartan/HCTZ regimens were generally as well tolerated as placebo
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 .