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Head-to-head comparisons of hydrochlorothiazide with indapamide and chlorthalidone: antihypertensive and metabolic effects.
Roush, George C; Ernst, Michael E; Kostis, John B; Tandon, Suraj; Sica, Domenic A.
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  • Roush GC; From the Department of Medicine, University of Connecticut School of Medicine and St. Vincent's Medical Center, Bridgeport (G.C.R., S.T.); Department of Family Medicine, University of Iowa Hospital and Clinics, Iowa City (M.E.E.); Department of Medicine, Cardiovascular Institute, University of Medic
  • Ernst ME; From the Department of Medicine, University of Connecticut School of Medicine and St. Vincent's Medical Center, Bridgeport (G.C.R., S.T.); Department of Family Medicine, University of Iowa Hospital and Clinics, Iowa City (M.E.E.); Department of Medicine, Cardiovascular Institute, University of Medic
  • Kostis JB; From the Department of Medicine, University of Connecticut School of Medicine and St. Vincent's Medical Center, Bridgeport (G.C.R., S.T.); Department of Family Medicine, University of Iowa Hospital and Clinics, Iowa City (M.E.E.); Department of Medicine, Cardiovascular Institute, University of Medic
  • Tandon S; From the Department of Medicine, University of Connecticut School of Medicine and St. Vincent's Medical Center, Bridgeport (G.C.R., S.T.); Department of Family Medicine, University of Iowa Hospital and Clinics, Iowa City (M.E.E.); Department of Medicine, Cardiovascular Institute, University of Medic
  • Sica DA; From the Department of Medicine, University of Connecticut School of Medicine and St. Vincent's Medical Center, Bridgeport (G.C.R., S.T.); Department of Family Medicine, University of Iowa Hospital and Clinics, Iowa City (M.E.E.); Department of Medicine, Cardiovascular Institute, University of Medic
Hypertension ; 65(5): 1041-6, 2015 May.
Article en En | MEDLINE | ID: mdl-25733245
Hydrochlorothiazide (HCTZ) has often been contrasted with chlorthalidone, but relatively little is known about HCTZ versus indapamide (INDAP). This systematic review retrieved 9765 publications, and from these, it identified 14 randomized trials with 883 patients comparing HCTZ with INDAP and chlorthalidone on antihypertensive potency or metabolic effects. To make fair comparisons, the dose of the diuretic in each arm was assigned 1 of 3 dose levels. In random effects meta-analysis, INDAP and chlorthalidone lowered systolic blood pressure more than HCTZ: -5.1 mm Hg (95% confidence interval, -8.7 to -1.6); P=0.004 and -3.6 mm Hg (95% confidence interval, -7.3 to 0.0); P=0.052, respectively. For both comparisons, there was minimal heterogeneity in effect across trials and no evidence for publication bias. The HCTZ-INDAP contrast was biased in favor of greater HCTZ potency because of a much greater contribution to the overall effect from trials in which the HCTZ arm had a higher dose level than the INDAP arm. For the HCTZ-INDAP comparison, no single trial was responsible for the overall result nor was it possible to detect significant modifications of this comparison by duration of follow-up, high- versus low-bias trials, or the presence or absence of background medications. There were no detectable differences between HCTZ and INDAP in metabolic adverse effects, including effects on serum potassium. In conclusion, these head-to-head comparisons demonstrate that, like chlorthalidone, INDAP is more potent than HCTZ at commonly prescribed doses without evidence for greater adverse metabolic effects.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Potasio / Presión Sanguínea / Clortalidona / Hidroclorotiazida / Hipertensión / Indapamida Tipo de estudio: Clinical_trials / Systematic_reviews Límite: Humans Idioma: En Revista: Hypertension Año: 2015 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Potasio / Presión Sanguínea / Clortalidona / Hidroclorotiazida / Hipertensión / Indapamida Tipo de estudio: Clinical_trials / Systematic_reviews Límite: Humans Idioma: En Revista: Hypertension Año: 2015 Tipo del documento: Article Pais de publicación: Estados Unidos