February 17, 2020JAMA Internal Medicine139 citationsOpen Access
Comparison of Cardiovascular and Safety Outcomes of Chlorthalidone vs Hydrochlorothiazide to Treat Hypertension
Structured PICO
Does chlorthalidone improve cardiovascular outcomes compared to hydrochlorothiazide in first-time users for hypertension treatment?
P
Population
First-time users requiring hypertension treatment
I
Intervention
Chlorthalidone
C
Comparator
Hydrochlorothiazide
O
Outcome
Cardiovascular outcomeshard clinical
In first-time users treated for hypertension, chlorthalidone does not offer cardiovascular benefits over hydrochlorothiazide and carries a higher risk of renal and electrolyte adverse events.
Abstract
This study found that chlorthalidone use was not associated with significant cardiovascular benefits when compared with hydrochlorothiazide, while its use was associated with greater risk of renal and electrolyte abnormalities. These findings do not support current recommendations to prefer chlorthalidone vs hydrochlorothiazide for hypertension treatment in first-time users was found. We used advanced methods, sensitivity analyses, and diagnostics, but given the possibility of residual confounding and the limited length of observation periods, further study is warranted.