Evidence-based Diuretics: Focus On Chlorthalidone and Indapamide

DiNicolantonio, James J; Bhutani, Jaikrit; Lavie, Carl J; O’Keefe, James H

doi:10.2217/fca.14.83

Cited by 29Blood Pressure and Hypertension StudiesSodium Intake and HealthClinical practice guidelines implementation

Evidence-based Diuretics: Focus On Chlorthalidone and Indapamide

DiNicolantonio, James J, Bhutani, Jaikrit, Lavie, Carl J, O’Keefe, James H·2015·Future Cardiology

DOI 10.2217/fca.14.83

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Abstract

Thiazide and thiazide-like diuretics are cornerstone treatments for hypertension. However, unlike chlorthalidone (CTD) and indapamide (IDP), hydrochlorothiazide (HCTZ) lacks evidence for reducing morbidity and mortality as monotherapy compared with placebo or control. Despite this fact, HCTZ is prescribed much more frequently than CTD or IDP. We believe that all hypertension guidelines should follow the National Institute for Health and Excellence (NICE) and make IDP and CTD first choice 'thiazide-like diuretics.' This article will focus on the available evidence pertaining to HCTZ versus CTD and IDP. We will review the pharmacological differences between these three diuretics, as well as the clinical trial data and important side effects.

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The diuretics with the greatest evidence base for reducing cardiovascular outcomes are the thiazide-like diuretics chlorthalidone and indapamide.
“The diuretics with the greatest evidence base for reducing cardiovascular outcomes are the thiazide-like diuretics chlorthalidone and indapamide.368,369”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [369]

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Authors: DiNicolantonio, J. J., Bhutani, J., Lavie, C. J., & O’Keefe, J. H.
Affiliations: Saint Luke's Hospital (US)
Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences (IN)
Pennington Biomedical Research Center (US)
ORCID: DiNicolantonio, James J
Bhutani, Jaikrit
Lavie, Carl J
O’Keefe, James H
Venue: Future Cardiology
Publisher: Informa UK Limited
Published: 2015-03
Volume: 11
Issue: 2
Pages: 203-217
ISSN: 1479-6678 (ISSN-L)
1744-8298
DOI: 10.2217/fca.14.83
OpenAlex: W2076448578
Cited by: 29
References: 105
Citations by year: 2026: 3 · 2025: 2 · 2024: 4 · 2022: 3 · 2021: 2 · 2020: 7 · 2019: 2 · 2018: 4 · 2017: 1 · 2014: 1
FWCI: 0.29
Type: journal article
Language: en
Open access: closed
Locations: Future Cardiology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
Keywords: chlorthalidone, indapamide, hydrochlorothiazide, thiazide-like diuretics, antihypertensive therapy, antihypertensive monotherapy, NICE guidelines, adverse effects, morbidity and mortality
MeSH terms: Antihypertensive Agents, Chlorthalidone, Diuretics, Humans, Hydrochlorothiazide, Hypertension, Indapamide

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Evidence-based Diuretics: Focus On Chlorthalidone and Indapamide

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