Chlorthalidone: Difference between revisions

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'''Chlorthalidone''' {{MedMasterPronounce|(klor thal' i done)|http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=medmaster.chapter.a682342}} is a [[medication]] used for treating [[hypertension]] in humans. Chlorthalidone is a thiazide-like [[diuretic]]. Compared to [[hydrochlorothiazide]], chlorthalidone is more potent and has a longer duration of action.<ref name="pmid14638621">{{cite journal |author=Carter BL, Ernst ME, Cohen JD |title=Hydrochlorothiazide versus chlorthalidone: evidence supporting their interchangeability |journal=Hypertension |volume=43 |issue=1 |pages=4–9 |year=2004 |month=January |pmid=14638621 |doi=10.1161/01.HYP.0000103632.19915.0E |url=http://hyper.ahajournals.org/cgi/pmidlookup?view=long&pmid=14638621 |issn=}}</ref><ref name="pmid16432050">{{cite journal |author=Ernst ME, Carter BL, Goerdt CJ, ''et al'' |title=Comparative antihypertensive effects of hydrochlorothiazide and chlorthalidone on ambulatory and office blood pressure |journal=Hypertension |volume=47 |issue=3 |pages=352–8 |year=2006 |month=March |pmid=16432050 |doi=10.1161/01.HYP.0000203309.07140.d3 |url=http://hyper.ahajournals.org/cgi/pmidlookup?view=long&pmid=16432050 |issn=}}</ref> This may result in improved outcomes.<ref name="pmid2225366">{{cite journal |author= |title=Mortality after 10 1/2 years for hypertensive participants in the Multiple Risk Factor Intervention Trial |journal=Circulation |volume=82 |issue=5 |pages=1616–28 |year=1990 |month=November |pmid=2225366 |doi= |url= |issn=}}</ref>
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'''Chlorthalidone''' {{MedMasterPronounce|(klor thal' i done)|http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=medmaster.chapter.a682342}} is a [[medication]] used for treating [[hypertension]] in humans. Chlorthalidone is a thiazide-like [[diuretic]]. Compared to [[hydrochlorothiazide]], chlorthalidone is more potent and has a longer duration of action.<ref name="pmid14638621">{{cite journal |author=Carter BL, Ernst ME, Cohen JD |title=Hydrochlorothiazide versus chlorthalidone: evidence supporting their interchangeability |journal=Hypertension |volume=43 |issue=1 |pages=4–9 |year=2004 |month=January |pmid=14638621 |doi=10.1161/01.HYP.0000103632.19915.0E |url=http://hyper.ahajournals.org/cgi/pmidlookup?view=long&pmid=14638621 |issn=}}</ref><ref name="pmid16432050">{{cite journal |author=Ernst ME, Carter BL, Goerdt CJ, ''et al'' |title=Comparative antihypertensive effects of hydrochlorothiazide and chlorthalidone on ambulatory and office blood pressure |journal=Hypertension |volume=47 |issue=3 |pages=352–8 |year=2006 |month=March |pmid=16432050 |doi=10.1161/01.HYP.0000203309.07140.d3 |url=http://hyper.ahajournals.org/cgi/pmidlookup?view=long&pmid=16432050 |issn=}}</ref> This may<ref name="pmid2225366">{{cite journal |author= |title=Mortality after 10 1/2 years for hypertensive participants in the Multiple Risk Factor Intervention Trial |journal=Circulation |volume=82 |issue=5 |pages=1616–28 |year=1990 |month=November |pmid=2225366 |doi= |url= |issn=}}</ref> or may not<ref name="pmid15238589">{{cite journal| author=Psaty BM, Lumley T, Furberg CD| title=Meta-analysis of health outcomes of chlorthalidone-based vs nonchlorthalidone-based low-dose diuretic therapies. | journal=JAMA | year= 2004 | volume= 292 | issue= 1 | pages= 43-4 | pmid=15238589 | doi=10.1001/jama.292.1.43-c | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15238589  }} </ref> result in improved outcomes.


==Effectiveness==
==Effectiveness==
Chlorthalidone reduced [[cardiovascular disease]] in the ALLHAT [[randomized controlled trial]] and was more effective than [[amlodipine]] and [[lisinopril]].<ref name="pmid12479763">{{cite journal |author= |title=Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) |journal=JAMA : the journal of the American Medical Association |volume=288 |issue=23 |pages=2981–97 |year=2002 |month=December |pmid=12479763 |doi= |url=http://jama.ama-assn.org/cgi/pmidlookup?view=long&pmid=12479763 |issn=}}</ref>
Chlorthalidone reduced [[cardiovascular disease]] in the ALLHAT [[randomized controlled trial]] and was more effective than [[amlodipine]] and [[lisinopril]].<ref name="pmid12479763">{{cite journal |author= |title=Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) |journal=JAMA : the journal of the American Medical Association |volume=288 |issue=23 |pages=2981–97 |year=2002 |month=December |pmid=12479763 |doi= |url=http://jama.ama-assn.org/cgi/pmidlookup?view=long&pmid=12479763 |issn=}}</ref>
Regarding chlorthalidone versus [[hydrochlorothiazide]]:
* Chlorthalidone better in a [[randomized controlled trial]].<ref name="pmid22939358">{{cite journal| author=Bakris GL, Sica D, White WB, Cushman WC, Weber MA, Handley A et al.| title=Antihypertensive Efficacy of Hydrochlorothiazide vs Chlorthalidone Combined with Azilsartan Medoxomil. | journal=Am J Med | year= 2012 | volume= 125 | issue= 12 | pages= 1229.e1-1229.e10 | pmid=22939358 | doi=10.1016/j.amjmed.2012.05.023 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22939358  }} </ref>
Regarding chlorthalidone versus calcium channel blockers:
*"Thiazide-type diuretics are superior in preventing 1 or more major forms of CVD and are less expensive" according to a [[randomized controlled trial]] that compared to . <ref  name="pmid12479763"/>
*"Similar  antihypertensive efficacies, tolerabilities and cardiovascular  event  rates were observed with verapamil and with chlorthalidone" according to  an unblinded [[randomized controlled trial]]<ref name="pmid9383184">{{cite journal| author=Rosei EA, Dal Palù C, Leonetti G, Magnani B, Pessina A, Zanchetti A| title=Clinical results of the Verapamil inHypertension and Atherosclerosis Study. VHAS Investigators. | journal=J Hypertens | year= 1997 | volume= 15 | issue= 11 | pages= 1337-44 | pmid=9383184 | doi= | pmc= | url= }} </ref>
*"In  elderly patients with isolated  systolic hypertension, administration  of lacidipine or chlorthalidone  markedly reduced systolic blood  pressure with no difference in the  incidence of cardiovascular events  and total mortality." according to an unblinded [[randomized controlled trial]]. <ref  name="pmid12875478">{{cite journal| author=Malacco E, Mancia G,  Rappelli A, Menotti A, Zuccaro MS, Coppini A et al.| title=Treatment of  isolated systolic hypertension: the SHELL study results. | journal=Blood  Press | year= 2003 | volume= 12 | issue= 3 | pages= 160-7 |  pmid=12875478 | doi= | pmc= | url= }} </ref>


==Indications==
==Indications==
===United States===
===United States===
Indications according to the [[United States]] [[Food and Drug Administration]] are:<ref>{{CZMed}}
Indications according to the [[United States of America]] [[Food and Drug Administration]] are:<ref>{{CZMed}}
</ref>
</ref>
* [[Diuretic]]s such as chlorthalidone are indicated in the management of hypertension either as the sole therapeutic agent or to enhance the effect of other antihypertensive drugs in the more severe forms of hypertension.
* [[Diuretic]]s such as chlorthalidone are indicated in the management of hypertension either as the sole therapeutic agent or to enhance the effect of other antihypertensive drugs in the more severe forms of hypertension.
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==References==
==References==
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==External links==
[[Category:Suggestion Bot Tag]]
{{CZMed}}

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Chlorthalidone (pronounced: (klor thal' i done) MedMaster) is a medication used for treating hypertension in humans. Chlorthalidone is a thiazide-like diuretic. Compared to hydrochlorothiazide, chlorthalidone is more potent and has a longer duration of action.[1][2] This may[3] or may not[4] result in improved outcomes.

Effectiveness

Chlorthalidone reduced cardiovascular disease in the ALLHAT randomized controlled trial and was more effective than amlodipine and lisinopril.[5]

Regarding chlorthalidone versus hydrochlorothiazide:

Regarding chlorthalidone versus calcium channel blockers:

  • "Thiazide-type diuretics are superior in preventing 1 or more major forms of CVD and are less expensive" according to a randomized controlled trial that compared to . [5]
  • "Similar antihypertensive efficacies, tolerabilities and cardiovascular event rates were observed with verapamil and with chlorthalidone" according to an unblinded randomized controlled trial[7]
  • "In elderly patients with isolated systolic hypertension, administration of lacidipine or chlorthalidone markedly reduced systolic blood pressure with no difference in the incidence of cardiovascular events and total mortality." according to an unblinded randomized controlled trial. [8]

Indications

United States

Indications according to the United States of America Food and Drug Administration are:[9]

  • Diuretics such as chlorthalidone are indicated in the management of hypertension either as the sole therapeutic agent or to enhance the effect of other antihypertensive drugs in the more severe forms of hypertension.
  • Chlorthalidone is indicated as adjunctive therapy in edema associated with congestive heart failure, hepatic cirrhosis, and corticosteroid and estrogen therapy.
  • Chlorthalidone has also been found useful in edema due to various forms of renal dysfunction, such as nephrotic syndrome, acute glomerulonephritis, and chronic renal failure.

References

  1. ↑ Carter BL, Ernst ME, Cohen JD (January 2004). "Hydrochlorothiazide versus chlorthalidone: evidence supporting their interchangeability". Hypertension 43 (1): 4–9. DOI:10.1161/01.HYP.0000103632.19915.0E. PMID 14638621. Research Blogging.
  2. ↑ Ernst ME, Carter BL, Goerdt CJ, et al (March 2006). "Comparative antihypertensive effects of hydrochlorothiazide and chlorthalidone on ambulatory and office blood pressure". Hypertension 47 (3): 352–8. DOI:10.1161/01.HYP.0000203309.07140.d3. PMID 16432050. Research Blogging.
  3. ↑ (November 1990) "Mortality after 10 1/2 years for hypertensive participants in the Multiple Risk Factor Intervention Trial". Circulation 82 (5): 1616–28. PMID 2225366. [e]
  4. ↑ Psaty BM, Lumley T, Furberg CD (2004). "Meta-analysis of health outcomes of chlorthalidone-based vs nonchlorthalidone-based low-dose diuretic therapies.". JAMA 292 (1): 43-4. DOI:10.1001/jama.292.1.43-c. PMID 15238589. Research Blogging.
  5. ↑ 5.0 5.1 (December 2002) "Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT)". JAMA : the journal of the American Medical Association 288 (23): 2981–97. PMID 12479763. [e]
  6. ↑ Bakris GL, Sica D, White WB, Cushman WC, Weber MA, Handley A et al. (2012). "Antihypertensive Efficacy of Hydrochlorothiazide vs Chlorthalidone Combined with Azilsartan Medoxomil.". Am J Med 125 (12): 1229.e1-1229.e10. DOI:10.1016/j.amjmed.2012.05.023. PMID 22939358. Research Blogging.
  7. ↑ Rosei EA, Dal Palù C, Leonetti G, Magnani B, Pessina A, Zanchetti A (1997). "Clinical results of the Verapamil inHypertension and Atherosclerosis Study. VHAS Investigators.". J Hypertens 15 (11): 1337-44. PMID 9383184. [e]
  8. ↑ Malacco E, Mancia G, Rappelli A, Menotti A, Zuccaro MS, Coppini A et al. (2003). "Treatment of isolated systolic hypertension: the SHELL study results.". Blood Press 12 (3): 160-7. PMID 12875478. [e]
  9. ↑ The most up-to-date information about Chlorthalidone and other drugs can be found at the following sites.

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