Are Chlorthalidone and Hydrochlorothiazide Equivalent Blood‐Pressure‐Lowering Medications?

Abstract

Only one large out-come trial, the Multiple Risk Factor Intervention Trial (MRFIT), used both HCTZ and CTD, but no head-to-head comparisons were performed. In MRFIT, after about 5 years patients who received each diuretic as initial therapy were compared against the common “referred care” group. For patients who used CTD as initial therapy, there was a trend indicating lower mortality compared with those using HCTZ. Use of CTD declined after research studies using high doses suggested an increased risk of cardiovascular deaths and a high incidence of hypokalemia.