USAFP Headlines Last Updated: 06/07/2013
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HCTZ versus Chlorthalidone for Treating Hypertension
Cohort study from Ontario, Canada. 10,000 patients in the chlorthalidone group and 20,000 in the HCTZ group, all age >65y/o. Followed for five years. Outcomes: composite of death from all causes or hospitalization for HF, CVA or MI.
After five years, composite outcomes no different between groups. However, those treated with chlorthalidone had the following increased adjusted hazard ratios (AHR): hypokalemia - 3.06; hyponatremia - 1.68. Consistent across dosing regimens.
THM (take-home message): patients treated with chlorthalidone need to be monitored for and taught about hypokalemia and hyponatremia more closely than those taking HCTZ.
Ann Intern Med 2013 Mar 19; 158:447.
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