Should We Give Up Hydrochlorothiazide as the Diuretic of Choice in Hypertension

The answer to this question could be considered as too normative, but a comparison between hydrochlorothiazide (HCTZ) and other diuretics available –particularly chlorthalidone (CT) and indapamide– would let us approach what would be the best choice of a diuretic for a scheme of antihypertensive treatment. Thiazide-related drugs are among the most commonly drugs used to treat hypertension; antihypertensive action and benefits to risk reduction for several final indicators have been widely documented (1) and should be included in all the schemes prior to considering refractory a patient who does not meet the therapeutic goals. Although there are several drugs in the group, the most commonly used –and almost exclusively in our environment– in clinical trials are HCTZ and CT; more recently, IP was introduced, and although it is classified as akin to this group, some of its characteristics are different.