SynthesisHypertension (Dallas, Tex. : 1979)2012
Chlorthalidone compared with hydrochlorothiazide in reducing cardiovascular events: systematic review and network meta-analyses.
Synthesis in Hypertension (Dallas, Tex. : 1979), 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 57 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
57 citing papers in PubMed, 5 syntheses or guidelines pooled it, 209 citations in OpenAlex.
- Combining angiotensin receptor blockers with chlorthalidone or hydrochlorothiazide - which is the better alternative? A meta-analysis.Systematic reviews · 2020Pooled it
- Hydrochlorothiazide vs chlorthalidone, indapamide, and potassium-sparing/hydrochlorothiazide diuretics for reducing left ventricular hypertrophy: A systematic review and meta-analysis.Journal of clinical hypertension (Greenwich, Conn.) · 2018Pooled it
- Thiazides in the management of hypertension in older adults - a systematic review.BMC geriatrics · 2017Pooled it
- 7th Brazilian Guideline of Arterial Hypertension: Chapter 7 - Pharmacological TreatmentArquivos brasileiros de cardiologia · 2016Guideline
- Guideline
- Antihypertensive Medication Regimens Used in the Systolic Blood Pressure Intervention Trial.Hypertension (Dallas, Tex. : 1979) · 2023Trial
- Comparative antiplatelet effects of chlorthalidone and hydrochlorothiazide.Journal of clinical hypertension (Greenwich, Conn.) · 2022Trial
- Comparison of long-term safety of fixed-dose combinations azilsartan medoxomil/chlorthalidone vs olmesartan medoxomil/hydrochlorothiazide.Journal of clinical hypertension (Greenwich, Conn.) · 2017Trial
- Resistant hypertension: Epidemiology, mechanisms and contemporary therapeutic strategies.Heart international · 2026Review
- Hydrochlorothiazide Is America's Most Popular Thiazide, But Should It Be?Journal of the American Heart Association · 2025Article
- The Evolving Role of Chlorthalidone and Hydrochlorothiazide as First-Line Treatments for Hypertensive Patients.Cureus · 2024Review
- Rationale for a New Low-Dose Triple Single Pill Combination for the Treatment of Hypertension.Global heart · 2024Article
- Thiazide Diuretic Utilization Within the VA.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2023Article
- Review
- Thiazide diuretics are back in CKD: the case of chlorthalidone.Clinical kidney journal · 2023Review
- 2022 Guidelines of the Taiwan Society of Cardiology and the Taiwan Hypertension Society for the Management of Hypertension.Acta Cardiologica Sinica · 2022Article
- Thiazide diuretics alone or in combination with a potassium-sparing diuretic on blood pressure-lowering in patients with primary hypertension: protocol for a systematic review and network meta-analysis.Systematic reviews · 2022Article
- Comparison of Clinical Outcomes and Safety Associated With Chlorthalidone vs Hydrochlorothiazide in Older Adults With Varying Levels of Kidney Function.JAMA network open · 2021Article
- Metal-Free Electrochemical Synthesis of Sulfonamides Directly from (Hetero)arenes, SOAngewandte Chemie (International ed. in English) · 2021Article
- Interamerican Society of Cardiology (IASC) position statement: Chlorthalidone vs. thiazide-International Journal of Cardiology. Hypertension · 2020Article
Corrections and comments
- Commented on by
Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Hydrochlorothiazide (HCTZ) is widely used for hypertension, and prescriptions for HCTZ outnumber those for chlorthalidone (CTDN) by >20-fold in 2 recent surveys. Some have recently expressed a preference for CTDN. However, head-to-head trials testing the effect of the 2 drugs on cardiovascular events (CVEs) are lacking. We conducted a systematic review of randomized trials in which 1 arm was based on either HCTZ or CTDN followed by 2 types of network meta-analyses, a drug-adjusted analysis and an office systolic blood pressure-adjusted analysis. Nine trials were identified: 3 based on HCTZ and 6 based on CTDN. In the drug-adjusted analysis (n = 50946), the percentage of risk reduction in congestive heart failure for CTDN versus HCTZ was 23 (95% CI, 2-39; P = 0.032); and in all CVEs was 21 (95% CI, 12-28; P<0.0001). In the office systolic blood pressure-adjusted analysis (n = 78350), the percentage of risk reduction in CVEs for CTDN versus HCTZ was 18 (95% CI, 3-30; P = 0.024). When the reduction in office systolic blood pressure was identical in the 2 arms, the risk for CVEs in HCTZ arms was 19% higher than in its nondiuretic comparator arms (P = 0.021). Relative to HCTZ, the number needed to treat with CTDN to prevent 1 CVE over 5 years was 27. In conclusion, CTDN is superior to HCTZ in preventing cardiovascular events. This cannot be attributed entirely to the lesser effect of HCTZ on office systolic blood pressure but may be attributed to the pleomorphic effects of alternative medications or to the short duration of action of HCTZ.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.