Hydrochlorothiazide Versus ChlorthalidoneEvidence Supporting Their Interchangeability
作者:
Barry Carter,
Michael Ernst,
Jerome Cohen,
期刊:
Hypertension: Journal of The American Heart Association
(OVID Available online 2004)
卷期:
Volume 43,
issue 1
页码: 4-9
ISSN:0194-911X
年代: 2004
出版商: OVID
关键词: clinical trials;diuretics;antihypertensive therapy;hypertension, detection and control
数据来源: OVID
摘要:
Abstract—Thiazide diuretics are one of the preferred pharmacologic treatments for hypertension. Hydrochlorothiazide and chlorthalidone have been the 2 most commonly used diuretics in major clinical trials. Treatment guidelines and compendia often consider these 2 drugs interchangeable agents within the class of thiazide or thiazide-like diuretics. Many sources list them as equipotent. Despite these beliefs, there is some suggestion that cardiovascular outcomes are not necessarily the same with these 2 drugs. We conducted a literature search from 1960 to 2003 to identify studies that evaluated the pharmacokinetic and blood pressure–lowering effects of these 2 agents. There are significant pharmacokinetic and pharmacodynamic differences between these diuretics. Chlorthalidone is ≈1.5 to 2.0 times as potent as hydrochlorothiazide, and the former has a much longer duration of action. Whether these pharmacokinetic and pharmacodynamic features cause differences in outcomes is not known.
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