How do hydrochlorothiazide and chlorthalidone compare for treating hypertension?
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Q. How do hydrochlorothiazide and chlorthalidone compare for treating hypertension? A. Both medications reduce theincidence of cardiovascular events in patients with hypertension, but chlorthalidone may confer additional cardiovascular risk reduction (strength of recommendation [SOR]: B, conflicting network meta-analysis and cohort studies). (No head-to-head studies of hydrochlorothiazide [HCTZ] and chlorthalidone have been done.) Serious hypokalemia and hyponatremia can occur with either medication; it is unclear if the rates of these adverse effects are the same at equivalent doses. Patients taking chlorthalidone are less likely to need a second antihypertensive medication but more likely to be nonadherent than patients taking HCTZ (SOR: B, cohort studies).
Journal of Family Practice, 63(4) 2014: 227-228