Key result
Chlorthalidone and indapamide, unlike hydrochlorothiazide, have evidence for reducing morbidity and mortality as monotherapy in hypertension, supporting their use as first-choice diuretics.
Why the study?
Should chlorthalidone and indapamide be preferred over hydrochlorothiazide for the treatment of hypertension?
Should chlorthalidone and indapamide be preferred over hydrochlorothiazide for the treatment of hypertension?
Chlorthalidone and indapamide are advocated as first-choice thiazide-like diuretics over hydrochlorothiazide due to stronger evidence for reducing morbidity and mortality.
May support preferring chlorthalidone or indapamide in hypertension; leaves open direct comparative outcome trials.
Thiazide and thiazide-like diuretics are cornerstone treatments for hypertension. However, unlike chlorthalidone (CTD) and indapamide (IDP), hydrochlorothiazide (HCTZ) lacks evidence for reducing morbidity and mortality as monotherapy compared with placebo or control. Despite this fact, HCTZ is prescribed much more frequently than CTD or IDP. We believe that all hypertension guidelines should follow the National Institute for Health and Excellence (NICE) and make IDP and CTD first choice 'thiazide-like diuretics.' This article will focus on the available evidence pertaining to HCTZ versus CTD and IDP. We will review the pharmacological differences between these three diuretics, as well as the clinical trial data and important side effects.
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DiNicolantonio et al. (2015) conducted a review in Hypertension. Chlorthalidone and Indapamide vs. Hydrochlorothiazide was evaluated. Chlorthalidone and indapamide, unlike hydrochlorothiazide, have evidence for reducing morbidity and mortality as monotherapy in hypertension, supporting their use as first-choice diuretics.
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