Chlorthalidone Versus Hydrochlorothiazide
Authors: Irfan A. Dhalla, Muhammad M. Mamdani, David N. Juurlink
Journal: Annals of Internal Medicine (2013)

Letters18 June 2013Chlorthalidone Versus HydrochlorothiazideIrfan A. Dhalla, MD, MSc, Muhammad M. Mamdani, PharmD, MA, MPH, and David N. Juurlink, MD, PhDIrfan A. Dhalla, MD, MScFrom St. Michael's Hospital, Toronto, Ontario, Canada; and Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.Search for more papers by this author, Muhammad M. Mamdani, PharmD, MA, MPHFrom St. Michael's Hospital, Toronto, Ontario, Canada; and Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.Search for more papers by this author, and David N. Juurlink, MD, PhDFrom St. Michael's Hospital, Toronto, Ontario, Canada; and Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-158-12-201306180-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We conducted a comparative effectiveness study to test whether chlorthalidone is superior to HCTZ in older adults as routinely prescribed in Ontario. To our surprise, our data did not support this hypothesis.As noted in our study, the network meta-analysis completed by Dr. Roush and colleagues suggests that chlorthalidone may be more effective than HCTZ in clinical trial settings (1). We also noted that additional data support the argument that chlorthalidone is superior to HCTZ (2, 3).There are several potential explanations of why our results yield a different conclusion. First, in the aforementioned network meta-analysis, most chlorthalidone ...References1. 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 Scholar2. Dorsch MP, Gillespie BW, Erickson SR, Bleske BE, Weder AB. Chlorthalidone reduces cardiovascular events compared with hydrochlorothiazide: a retrospective cohort analysis. Hypertension. 2011;57:689-94. [PMID: 21383313] CrossrefMedlineGoogle Scholar3. Ernst ME, Carter BL, Goerdt CJ, Steffensmeier JJ, Phillips BB, Zimmerman MB, et al. Comparative antihypertensive effects of hydrochlorothiazide and chlorthalidone on ambulatory and office blood pressure. Hypertension. 2006;47:352-8. [PMID: 16432050] CrossrefMedlineGoogle Scholar4. Peterzan MA, Hardy R, Chaturvedi N, Hughes AD. Meta-analysis of dose-response relationships for hydrochlorothiazide, chlorthalidone, and bendroflumethiazide on blood pressure, serum potassium, and urate. Hypertension. 2012;59:1104-9. [PMID: 22547443] CrossrefMedlineGoogle Scholar5. Gandhi S, Shariff SZ, Fleet JL, Weir MA, Jain AK, Garg AX. Validity of the International Classification of Diseases 10th revision code for hospitalisation with hyponatraemia in elderly patients. BMJ Open. 2012;2:. [PMID: 23274673] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From St. Michael's Hospital, Toronto, Ontario, Canada; and Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M12-1038. 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 George C. Roush , Theodore R. Holford , and Achuta K. Guddati Chlorthalidone Versus Hydrochlorothiazide James J. DiNicolantonio , James H. O'Keefe , and Carl J. Lavie Chlorthalidone Versus Hydrochlorothiazide Robert G. Badgett Chlorthalidone Versus Hydrochlorothiazide Alberto Donzelli Chlorthalidone Versus Hydrochlorothiazide Paula T. Einhorn , William C. Cushman , Paul K. Whelton , and Metrics Cited ByChlorthalidone Versus Hydrochlorothiazide in Hypertension Treatment: Do We Have the Evidence to Decide? 18 June 2013Volume 158, Issue 12Page: 923-924KeywordsClinical trialsDrugsElderlyHypertensionHyponatremiaHypotensionNetwork analysisPopulation statisticsPotassium ePublished: 18 June 2013 Issue Published: 18 June 2013 CopyrightCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...