Chlorthalidone Versus Hydrochlorothiazide
Authors: James J. DiNicolantonio, James H. O'Keefe, Carl J. Lavie
Journal: Annals of Internal Medicine (2013)

Letters18 June 2013Chlorthalidone Versus HydrochlorothiazideJames J. DiNicolantonio, PharmD, James H. O'Keefe, MD, and Carl J. Lavie, MDJames J. DiNicolantonio, PharmDFrom Wegmans Pharmacy, Ithaca, New York; Mid America Heart Institute, University of Missouri, Kansas City, Missouri; and John Ochsner Heart and Vascular Institute, Ochsner Clinical School–The University of Queensland School of Medicine, New Orleans, Louisiana.Search for more papers by this author, James H. O'Keefe, MDFrom Wegmans Pharmacy, Ithaca, New York; Mid America Heart Institute, University of Missouri, Kansas City, Missouri; and John Ochsner Heart and Vascular Institute, Ochsner Clinical School–The University of Queensland School of Medicine, New Orleans, Louisiana.Search for more papers by this author, and Carl J. Lavie, MDFrom Wegmans Pharmacy, Ithaca, New York; Mid America Heart Institute, University of Missouri, Kansas City, Missouri; and John Ochsner Heart and Vascular Institute, Ochsner Clinical School–The University of Queensland School of Medicine, New Orleans, Louisiana.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-158-12-201306180-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Dhalla and colleagues (1) state, “As typically prescribed, chlorthalidone in older adults was not associated with fewer adverse cardiovascular events or deaths than hydrochlorothiazide. However, it was associated with a greater incidence of electrolyte abnormalities, particularly hypokalemia.” This observational cohort study is contrary to a meta-analysis of 108 clinical trials, which indicated that reductions in potassium levels were considered equivalent between chlorthalidone and HCTZ when they were used in the dose range between 12.5 and 25.0 mg (2). In addition, data from MRFIT (Multiple Risk Factor Intervention Trial) indicate that chlorthalidone significantly reduces CVEs compared with HCTZ ...References1. Dhalla IA, Gomes T, Yao Z, Nagge J, Persaud N, Hellings C, et al. Chlorthalidone versus hydrochlorothiazide for the treatment of hypertension in older adults: a population-based cohort study. Ann Intern Med. 2013;158:447-55. [PMID: 23552325] LinkGoogle Scholar2. Ernst ME, Carter BL, Zheng S, Grimm RH. Meta-analysis of dose-response characteristics of hydrochlorothiazide and chlorthalidone: effects on systolic blood pressure and potassium. Am J Hypertens. 2010;23:440-6. [PMID: 20111008] CrossrefMedlineGoogle Scholar3. Roush GC, Holford TR, Guddati AK. Chlorthalidone compared with hydrochlorothiazide in reducing cardiovascular events: systematic review and network meta-analyses. Hypertension. 2012;59:1110-7. [PMID: 22526259] CrossrefMedlineGoogle Scholar4. DiNicolantonio JJ. Hydrochlorothiazide: is it a wise choice? Expert Opin Pharmacother. 2012;13:807-14. [PMID: 22424420] CrossrefMedlineGoogle Scholar5. Al Badarin FJ, Lavie CJ, O'Keefe JH. The last nail in hydrochlorothiazide's coffin? Ochsner J. 2012;12:4-6. [PMID: 22438773] MedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Wegmans Pharmacy, Ithaca, New York; Mid America Heart Institute, University of Missouri, Kansas City, Missouri; and John Ochsner Heart and Vascular Institute, Ochsner Clinical School–The University of Queensland School of Medicine, New Orleans, Louisiana.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoChlorthalidone Versus Hydrochlorothiazide for the Treatment of Hypertension in Older Adults Irfan A. Dhalla , Tara Gomes , Zhan Yao , Jeff Nagge , Navindra Persaud , Chelsea Hellings , Muhammad M. Mamdani , and David N. Juurlink Chlorthalidone Versus Hydrochlorothiazide Robert G. Badgett Chlorthalidone Versus Hydrochlorothiazide Alberto Donzelli Chlorthalidone Versus Hydrochlorothiazide Paula T. Einhorn , William C. Cushman , Paul K. Whelton , and Chlorthalidone Versus Hydrochlorothiazide Irfan A. Dhalla , Muhammad M. Mamdani , and David N. Juurlink Chlorthalidone Versus Hydrochlorothiazide George C. Roush , Theodore R. Holford , and Achuta K. Guddati Metrics Cited byIt Takes the Right Medications to Prevent a Million Heart Attacks and Strokes 18 June 2013Volume 158, Issue 12Page: 920-921KeywordsClinical trialsFibroblastsGrowth factorsHeart failureMedical risk factorsNervesNetwork analysisPlatelet aggregationPotassium ePublished: 18 June 2013 Issue Published: 18 June 2013 Copyright & PermissionsCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...