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Which diuretic is better for treating patients with hypertension: chlorthalidone or hydrochlorothiazide (HCTZ)? Researchers in the U.S. Veterans Affairs healthcare system addressed this question in a large head-to-head trial.
Nearly 14,000 patients with hypertension (age, ≥65) who were already taking HCTZ (25–50 mg daily) were randomized either to continue HCTZ or to switch to chlorthalidone (12.5–25 mg daily). At baseline, most patients were taking the 25-mg HCTZ dose plus one or two additional antihypertensive drugs, and about 15% had prior myocardial infarction (MI), stroke, or heart failure.
During median follow-up of 2.4 years, the primary composite outcome (i.e., MI, stroke, heart failure hospitalization, urgent coronary revascularizati…