ArticleJournal of clinical hypertension (Greenwich, Conn.)2012
The comparative effectiveness of hydrochlorothiazide and chlorthalidone in an observational cohort of veterans.
Article in Journal of clinical hypertension (Greenwich, Conn.), 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis 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
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- Efficacy and Safety of Chlortalidone and Hydrochlorothiazide in Prevention of Cardiovascular Diseases.Reviews in cardiovascular medicine · 2024Pooled it
- A randomized trial of the efficacy and safety of azilsartan medoxomil combined with chlorthalidone.Journal of the renin-angiotensin-aldosterone system : JRAASTrial
- Review
- Comparison of Clinical Outcomes and Safety Associated With Chlorthalidone vs Hydrochlorothiazide in Older Adults With Varying Levels of Kidney Function.JAMA network open · 2021Article
- Synchronous Spectrofluorimetry Coupled with Third-Order Derivative Signal Processing for the Simultaneous Quantitation of Telmisartan and Chlorthalidone Drug Combination in Human Plasma.Journal of fluorescence · 2021Article
- Pharmacogenomics of Hypertension Treatment.International journal of molecular sciences · 2020Review
- Pharmacogenomics of amlodipine and hydrochlorothiazide therapy and the quest for improved control of hypertension: a mini review.Heart failure reviews · 2019Review
- Treatment of hypertension in CKD patients with azilsartan/chlorthalidone vs olmesartan/hydrochlorothiazide.Journal of clinical hypertension (Greenwich, Conn.) · 2018Article
- Engineering practice variation through provider agreement: a cluster-randomized feasibility trial.Therapeutics and clinical risk management · 2014Article
- The Antihypertensive Efficacy of Chlorthalidone and Telmisartan in Indian Hypertensive Patients who were Uncontrolled with Hydrochlorothiazide and Telmisartan Combination-A Prospective and an Open Label Study.Journal of clinical and diagnostic research : JCDR · 2013Article
- Optimizing combination therapy in the management of hypertension: the role of the aliskiren, amlodipine, and hydrochlorothiazide fixed combination.Integrated blood pressure control · 2013Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Indirect evidence suggests that chlorthalidone may be more effective than hydrochlorothiazide (HCTZ), but direct comparisons are lacking. Using national Veterans Administrative pharmacy data from 2003 to 2008, the authors performed a retrospective cohort study examining the effectiveness of chlorthalidone and HCTZ among new thiazide users. For 1 year following the thiazide start, rates of persistence of thiazide use, adequacy of response (defined as the absence of additional new antihypertensive medications following thiazide initiation), and an overall composite of treatment effectiveness incorporating both outcomes were examined. In this cohort of >125,000 individuals, persistence of thiazide use was higher for HCTZ than chlorthalidone (72.0% vs 62.0%; P<.001), but among thiazide-persistent users, more HCTZ users had additional antihypertensives added compared with chlorthalidone (76.4% vs 70.1%; P<.001). The overall composite treatment response (thiazide persistence and no antihypertensive additions) revealed a slight advantage for HCTZ over chlorthalidone (50.7% vs 47.4%; P=.002). These findings remained consistent after adjustment using multivariable logistic regression. This study provides real-world clinical data supporting a potential efficacy advantage of chlorthalidone among patients who tolerate the drug and remain persistent with treatment; however, strategies to optimize the way chlorthalidone is prescribed in clinical practice are necessary to increase its overall effectiveness relative to HCTZ.
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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.