Effect of Hydrochlorothiazide and Chlorthalidone on Recently Diagnosed Hypertensives: A Comparative Approach | Chapter 6 | New Frontiers in Medicine and Medical Research Vol. 6

 The thiazides hydrochlorthiazide and chlorthalidone are the two most commonly prescribed thiazides for hypertension. The usage of chlorthalidone, which is more powerful and has a longer half-life, can help to reduce metabolic abnormalities, particularly hypokalaemia.

The primary line of treatment for stable, uncomplicated essential hypertension has been thiazide diuretics, with hydrochlorothiazide (HCTZ) being the most popular. Another thiazide, chlorthalidone, has been around for a while and is said to be just as effective, if not more so, in treating primary hypertension.

The purpose of this study was to compare the efficacy and safety of HCTZ and chlorthalidone in treating primary essential hypertension.

Methods: In a randomised, single-blinded, intention-to-treat research, we compared these two medications. For a 12-week period, participants with essential hypertension were given either chlorthalidone 12.5 mg OD or HCTZ 25 mg OD. The findings were compared using 12 hourly ambulatory blood pressure (BP) monitoring, fortnightly serum potassium records, and treatment failure (i.e., the need of additional antihypertensive drug or incrementation in the dose of thiazides).

Our study had 114 participants, 44 in the chlorthalidone group and 39 in the HCTZ group. In group H receiving HCTZ 25 mg OD, there was a significant mean drop in BP of 11.89/9.86 in the morning and 11.12/7.56 in the evening. The mean fall in the chlorthalidone group was 16.45/12.38 in the morning and 15.73/10.86 in the evening. After 12 weeks, the chlorthalidone group (127.915.01) had superior nighttime BP control than the HCTZ group (132.675.19) (p=0.001). Both medications reduced serum potassium levels, however HCTZ did so somewhat more (3.7770.601 vs. 3.8910.534), a difference that was statistically insignificant when compared to each other (p>0.05).

Conclusion: Chlorthalidone is more effective than HCTZ at controlling blood pressure throughout the day without causing serious side effects.

Author (S) Details

Bijay Kumar
Department of Pharmacology, Maharishi Markandeshwar Medical College and Hospital, Kumarhatti, Solan, Himachal Pradesh, India.

Sharanjit Kaur
Department of Pharmacology, Maharishi Markandeshwar Medical College and Hospital, Kumarhatti, Solan, Himachal Pradesh, India.

Sami Manzoor
Department of Pharmacology, Maharishi Markandeshwar Medical College and Hospital, Kumarhatti, Solan, Himachal Pradesh, India.

Harinder Jot Singh
Department of Physiology, Maharishi Markandeshwar Medical College and Hospital, Kumarhatti, Solan, Himachal Pradesh, India.


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