What does this research mean for the field?

Hydrochlorothiazide has a dose-dependent blood pressure-lowering effect in primary hypertension, whereas other thiazides achieve maximal reduction at their lowest studied doses, and as a class, thiazides reduce pulse pressure more than other common antihypertensives. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

May 29, 2014Cochrane libraryOpen Access

Blood pressure-lowering efficacy of monotherapy with thiazide diuretics for primary hypertension

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Why the study?

Does fixed-dose thiazide diuretic monotherapy reduce systolic and diastolic blood pressure compared to placebo in adult patients with primary hypertension?

Population

11,282 adult patients with primary hypertension from 60 RCTs, mean age 55 years, baseline blood pressure…

Comparison

Fixed-dose thiazide diuretic monotherapy for 3… vs Placebo control.

Design

Meta-analysis, randomized, double-blind

Follow-up

mean 8 weeks (range 3 to 12 weeks)

Authors

VMVijaya M MusiniUniversity of British Columbia MNMark A. NazerUniversity of British Columbia KBKen BassettUniversity of British Columbia

Discussion

Member takes

Implication

Thiazides lower BP as monotherapy in primary hypertension; confirms efficacy across RCTs and supports guideline recommendations.

Structured PICO

Does fixed-dose thiazide diuretic monotherapy reduce systolic and diastolic blood pressure compared to placebo in adult patients with primary hypertension?

Population

11,282 adult patients with primary hypertension from 60 RCTs, mean age 55 years, baseline blood pressure 158/99 mmHg.

Intervention

Fixed-dose thiazide diuretic monotherapy (hydrochlorothiazide, chlorthalidone, indapamide, bendrofluazide, cyclopenthiazide, or metolazone) for 3 to 12 weeks (mean duration 8 weeks).

Comparator

Placebo control.

Outcome

Dose-related decrease in systolic and/or diastolic blood pressure.surrogate

Thiazide diuretics effectively lower blood pressure and pulse pressure in primary hypertension, with hydrochlorothiazide demonstrating a clear dose-dependent effect, though they are associated with adverse metabolic changes.

Limitations

90% of included trials had unclear or high risk of bias
High risk of bias in the metabolic data
High risk of bias in the reporting of withdrawals due to adverse effects

Cite This Study

Musini et al. (2014) studied this question.

synapsesocial.com/papers/6a1bde8f1567d2fc4d5f2b22 https://doi.org/10.1002/14651858.cd003824.pub2

Topics

Hypertension management

View Full Paper

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May 29, 2014Cochrane libraryOpen Access

Blood pressure-lowering efficacy of monotherapy with thiazide diuretics for primary hypertension

View Full Paper

Ask AI

Bookmark

Why the study?

Does fixed-dose thiazide diuretic monotherapy reduce systolic and diastolic blood pressure compared to placebo in adult patients with primary hypertension?

Population

11,282 adult patients with primary hypertension from 60 RCTs, mean age 55 years, baseline blood pressure…

Comparison

Fixed-dose thiazide diuretic monotherapy for 3… vs Placebo control.

Design

Meta-analysis, randomized, double-blind

Follow-up

mean 8 weeks (range 3 to 12 weeks)

Authors

VMVijaya M MusiniUniversity of British Columbia MNMark A. NazerUniversity of British Columbia KBKen BassettUniversity of British Columbia

Discussion

Member takes

Implication

Thiazides lower BP as monotherapy in primary hypertension; confirms efficacy across RCTs and supports guideline recommendations.

Structured PICO

Does fixed-dose thiazide diuretic monotherapy reduce systolic and diastolic blood pressure compared to placebo in adult patients with primary hypertension?

Population

11,282 adult patients with primary hypertension from 60 RCTs, mean age 55 years, baseline blood pressure 158/99 mmHg.

Intervention

Fixed-dose thiazide diuretic monotherapy (hydrochlorothiazide, chlorthalidone, indapamide, bendrofluazide, cyclopenthiazide, or metolazone) for 3 to 12 weeks (mean duration 8 weeks).

Comparator

Placebo control.

Outcome

Dose-related decrease in systolic and/or diastolic blood pressure.surrogate

Limitations

90% of included trials had unclear or high risk of bias
High risk of bias in the metabolic data
High risk of bias in the reporting of withdrawals due to adverse effects

Cite This Study

Musini et al. (2014) studied this question.

synapsesocial.com/papers/6a1bde8f1567d2fc4d5f2b22 https://doi.org/10.1002/14651858.cd003824.pub2

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

Topics

Hypertension management

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