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Antihypertensive Drugs: Thiazide-Class Diuretics

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Related Experiment Video

Updated: May 24, 2026

Hydra, a Computer-Based Platform for Aiding Clinicians in Cardiovascular Analysis and Diagnosis

Hydra, a Computer-Based Platform for Aiding Clinicians in Cardiovascular Analysis and Diagnosis

Published on: September 26, 2018

Hydrochlorothiazide: is it a wise choice?

James J DiNicolantonio¹

¹Wegmans Pharmacy, 500 South Meadow Street, Ithaca, NY 14850, USA. jjdinicol@gmail.com

Expert Opinion on Pharmacotherapy

|March 20, 2012

Summary

This summary is machine-generated.

Hydrochlorothiazide (HCTZ) is widely prescribed but lacks evidence for reducing cardiovascular events and may increase risks. Chlorthalidone and indapamide are recommended alternatives due to better data and safety profiles.

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The Antihypertensive Effects and Mechanisms of Huotan Jiedu Tongluo Decoction in Rats with H-Type Hypertension

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Published on: May 17, 2024

Area of Science:

Pharmacology
Cardiovascular Medicine
Clinical Trials

Background:

Hydrochlorothiazide (HCTZ) is the most prescribed diuretic in the U.S. despite lacking evidence for reducing mortality or cardiovascular events.
Two randomized trials indicated HCTZ may increase cardiovascular death and coronary artery disease (CAD) compared to placebo.
Current guidelines do not differentiate between thiazide diuretics, but clinical data favors chlorthalidone and indapamide over HCTZ.

Purpose of the Study:

To compare the pharmacological profiles of HCTZ, chlorthalidone, and indapamide.
To review surrogate marker data for these diuretics.
To analyze clinical trial data comparing HCTZ, chlorthalidone, and indapamide.

Main Methods:

Literature review of pharmacological properties.
Analysis of surrogate marker studies.
Synthesis of data from randomized controlled trials.

Main Results:

Chlorthalidone and indapamide possess distinct pharmacological profiles compared to HCTZ.
Evidence from surrogate markers and clinical trials suggests superior efficacy and safety for chlorthalidone and indapamide.
HCTZ has not demonstrated benefits in reducing cardiovascular outcomes and may carry risks.

Conclusions:

The term 'thiazide diuretic' should be revised to 'non-thiazide sulfonamide diuretic' for chlorthalidone and indapamide.
Chlorthalidone and indapamide should be recommended over HCTZ due to a stronger evidence base and potential harm associated with HCTZ.
Revising diuretic recommendations can improve cardiovascular outcomes and patient safety.