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Which diuretic should be recommended for first-line treatment of patients with hypertension? To address this question, investigators used retrospective data from three U.S. administrative claims databases to compare about 37,000 patients who received chlorthalidone and 693,000 patients who received hydrochlorothiazide.
In analyses adjusted extensively for potential confounding factors, researchers found no differences between groups for any cardiac endpoint (i.e., myocardial infarction, hospitalization for heart failure, hemorrhagic or ischemic stroke, and a composite measure of these three outcomes plus sudden cardiac-related death). Significant relative differences favored hydrochlorothiazide for a few safety outcomes (e.g., hypokalemia), …