Medical Dialogues
  • Dermatology
Login Register
This site is intended for healthcare professionals only
Login Register
  • MD Brand Connect
  • Vaccine Hub
  • MDTV
    • Breaking News
    • Medical News Today
    • Health News Today
    • Latest
    • Journal Club
    • Medico Legal Update
    • Latest Webinars
    • MD Shorts
    • Health Dialogues
  • Fact Check
  • Health Dialogues
Medical Dialogues
  • Medical News & Guidelines
      • Anesthesiology
      • Cardiology and CTVS
      • Critical Care
      • Dentistry
      • Dermatology
      • Diabetes and Endocrinology
      • ENT
      • Gastroenterology
      • Medicine
      • Nephrology
      • Neurology
      • Obstretics-Gynaecology
      • Oncology
      • Ophthalmology
      • Orthopaedics
      • Pediatrics-Neonatology
      • Psychiatry
      • Pulmonology
      • Radiology
      • Surgery
      • Urology
      • Laboratory Medicine
      • Diet
      • Nursing
      • Paramedical
      • Physiotherapy
  • Health news
      • Doctor News
      • Government Policies
      • Hospital & Diagnostics
      • International Health News
      • Medical Organization News
      • Medico Legal News
      • NBE News
      • NMC News
  • Fact Check
      • Bone Health Fact Check
      • Brain Health Fact Check
      • Cancer Related Fact Check
      • Child Care Fact Check
      • Dental and oral health fact check
      • Diabetes and metabolic health fact check
      • Diet and Nutrition Fact Check
      • Eye and ENT Care Fact Check
      • Fitness fact check
      • Gut health fact check
      • Heart health fact check
      • Kidney health fact check
      • Medical education fact check
      • Men's health fact check
      • Respiratory fact check
      • Skin and hair care fact check
      • Vaccine and Immunization fact check
      • Women's health fact check
  • AYUSH
    • Ayurveda
    • Homeopathy
    • Siddha
    • Unani
    • Yoga
  • State News
      • Andaman and Nicobar Islands
      • Andhra Pradesh
      • Arunachal Pradesh
      • Assam
      • Bihar
      • Chandigarh
      • Chattisgarh
      • Dadra and Nagar Haveli
      • Daman and Diu
      • Delhi
      • Goa
      • Gujarat
      • Haryana
      • Himachal Pradesh
      • Jammu & Kashmir
      • Jharkhand
      • Karnataka
      • Kerala
      • Ladakh
      • Lakshadweep
      • Madhya Pradesh
      • Maharashtra
      • Manipur
      • Meghalaya
      • Mizoram
      • Nagaland
      • Odisha
      • Puducherry
      • Punjab
      • Rajasthan
      • Sikkim
      • Tamil Nadu
      • Telangana
      • Tripura
      • Uttar Pradesh
      • Uttrakhand
      • West Bengal
  • Medical Education
      • Ayush Education News
      • Dentistry Education News
      • Medical Admission News
      • Medical Colleges News
      • Medical Courses News
      • Medical Universities News
      • Nursing education News
      • Paramedical Education News
      • Study Abroad
  • Industry
      • Health Investment News
      • Health Startup News
      • Medical Devices News
      • Pharma News
      • Pharmacy Education News
      • Industry Perspective
  • MDTV
      • Health Dialogues MDTV
      • Health News today MDTV
      • Latest Videos MDTV
      • Latest Webinars MDTV
      • MD shorts MDTV
      • Medical News Today MDTV
      • Medico Legal Update MDTV
      • Top Videos MDTV
      • Health Perspectives MDTV
      • Journal Club MDTV
      • Medical Dialogues Show
This site is intended for healthcare professionals only
LoginRegister
Medical Dialogues
LoginRegister
  • Home
  • Medical news & Guidelines
    • Anesthesiology
    • Cardiology and CTVS
    • Critical Care
    • Dentistry
    • Dermatology
    • Diabetes and Endocrinology
    • ENT
    • Gastroenterology
    • Medicine
    • Nephrology
    • Neurology
    • Obstretics-Gynaecology
    • Oncology
    • Ophthalmology
    • Orthopaedics
    • Pediatrics-Neonatology
    • Psychiatry
    • Pulmonology
    • Radiology
    • Surgery
    • Urology
    • Laboratory Medicine
    • Diet
    • Nursing
    • Paramedical
    • Physiotherapy
  • Health news
    • Doctor News
    • Government Policies
    • Hospital & Diagnostics
    • International Health News
    • Medical Organization News
    • Medico Legal News
    • NBE News
    • NMC News
  • Fact Check
    • Bone Health Fact Check
    • Brain Health Fact Check
    • Cancer Related Fact Check
    • Child Care Fact Check
    • Dental and oral health fact check
    • Diabetes and metabolic health fact check
    • Diet and Nutrition Fact Check
    • Eye and ENT Care Fact Check
    • Fitness fact check
    • Gut health fact check
    • Heart health fact check
    • Kidney health fact check
    • Medical education fact check
    • Men's health fact check
    • Respiratory fact check
    • Skin and hair care fact check
    • Vaccine and Immunization fact check
    • Women's health fact check
  • AYUSH
    • Ayurveda
      • Ayurveda Giuidelines
      • Ayurveda News
    • Homeopathy
      • Homeopathy Guidelines
      • Homeopathy News
    • Siddha
      • Siddha Guidelines
      • Siddha News
    • Unani
      • Unani Guidelines
      • Unani News
    • Yoga
      • Yoga Guidelines
      • Yoga News
  • State News
    • Andaman and Nicobar Islands
    • Andhra Pradesh
    • Arunachal Pradesh
    • Assam
    • Bihar
    • Chandigarh
    • Chattisgarh
    • Dadra and Nagar Haveli
    • Daman and Diu
    • Delhi
    • Goa
    • Gujarat
    • Haryana
    • Himachal Pradesh
    • Jammu & Kashmir
    • Jharkhand
    • Karnataka
    • Kerala
    • Ladakh
    • Lakshadweep
    • Madhya Pradesh
    • Maharashtra
    • Manipur
    • Meghalaya
    • Mizoram
    • Nagaland
    • Odisha
    • Puducherry
    • Punjab
    • Rajasthan
    • Sikkim
    • Tamil Nadu
    • Telangana
    • Tripura
    • Uttar Pradesh
    • Uttrakhand
    • West Bengal
  • Medical Education
    • Ayush Education News
    • Dentistry Education News
    • Medical Admission News
    • Medical Colleges News
    • Medical Courses News
    • Medical Universities News
    • Nursing education News
    • Paramedical Education News
    • Study Abroad
  • Industry
    • Health Investment News
    • Health Startup News
    • Medical Devices News
    • Pharma News
      • CDSCO (Central Drugs Standard Control Organisation) News
    • Pharmacy Education News
    • Industry Perspective
  • Home
  • Cardiology-CTVS
  • Cardiology & CTVS News
  • Chlorthalidone use...

Chlorthalidone use linked to higher hypokalemia rates than hydrochlorothiazide: JAMA

Written By : Dr. Kamal Kant Kohli Published On 2020-02-18T10:36:35+05:30  |  Updated On 18 Oct 2023 3:19 PM IST
Chlorthalidone use linked to higher hypokalemia rates than hydrochlorothiazide: JAMA
  • facebook
  • twitter
  • linkedin
  • whatsapp
  • Telegram
  • Email

Diuretics have demonstrated favorable blood pressure lowering efficacy, but the equivalent doses of their more common agents, chlorthalidone and hydrochlorothiazide, are still unclear.

Researchers at Columbia University Irving Medical Center have found thath chlorthalidone the guideline-recommended diuretic for lowering blood pressure, causes more serious side effects than hydrochlorothiazide, a similarly effective diuretic. Hypokalemia rates remained higher for patients taking chlorthalidone even when given at a lower dose than hydrochlorothiazide.

The findings have been published in JAMA Internal Medicine.The findings of The study contrast with current treatment guidelines recommending chlorthalidone over hydrochlorothiazide.

The researchers found that patients taking chlorthalidone had nearly three times the risk of developing dangerously low levels of potassium and a greater risk of other electrolyte imbalances and kidney problems compared with those taking hydrochlorothiazide. Information from the largest individual database studied by the team revealed that 6.3% of patients treated with chlorthalidone experienced hypokalemia (low blood potassium), compared with 1.9% of patients who were treated with hydrochlorothiazide.

"Doctors prescribing chlorthalidone should monitor for certain side effects in their patients," says George Hripcsak, MD, MS, chair and Vivian Beaumont Allen Professor of Biomedical Informatics at Columbia University Vagelos College of Physicians and Surgeons and lead author of the study.

The study, which looked at 17 years of data on more than 730,000 individuals treated for hypertension, is the largest multisite analysis directly comparing the two antihypertensive drugs in the general patient population.

The results were generated by the Large-Scale Evidence Generation and Evaluation in a Network of Databases (LEGEND) Hypertension study, a method for analyzing data in millions of electronic health records around the world developed by the Observational Health Data Sciences and Informatics (OHDSI) network, which has a central coordinating center at Columbia University.

An earlier LEGEND Hypertension study, published in The Lancet, found that thiazide diuretics were more effective and caused fewer side effects than ACE inhibitors when used as first-line antihypertensive drugs.

In the current paper, the researchers found that chlorthalidone and hydrochlorothiazide were similarly effective in preventing heart attack, hospitalization for heart failure, and stroke. However, patients treated with chlorthalidone had a significantly higher risk of side effects, including hypokalemia, which can lead to abnormal heart rhythms; hyponatremia (low sodium), which can cause confusion; kidney failure; and type 2 diabetes.

"The difference in the occurrence of side effects was striking," says Hripcsak. "Hypokalemia, hyponatremia, chronic and acute kidney problems, along with other electrolyte imbalances, are all potentially dangerous side effects."

The new study is not the first to find side effects associated with chlorthalidone. A previous observational study found that the drug was associated with more electrolyte imbalances than hydrochlorothiazide.

Nearly 95% of patients in the study were first treated with hydrochlorothiazide, which was the preferred diuretic for treating hypertension throughout most of the study period (2001-2018). However, in 2017, the American College of Cardiology and American Heart Association issued new guidelines favoring chorothalidone, based on the drug's longer half-life and indirect evidence that it may be more effective in reducing cardiovascular risk.

"Until we have more studies directly comparing the two diuretics, we don't really know whether the risk of the side effects seen in observational studies outweighs the potential cardiovascular benefits," says Hripcsak, who notes that the VA Office of Research and Development is now conducting a randomized clinical trial to help settle the debate.

The research team performed several sensitivity analyses (time at risk, blood pressure, dose), as well as other best practices developed within the OHDSI network (including propensity scoring and the use of negative controls) to ensure a lack of bias in the results. These best practices are used throughout the LEGEND project, which OHDSI collaborators believe will continue to impact critical decisions in health care. These analyses ensure that the compared groups are similar in severity of illness, comorbidities, baseline blood pressures, age, sex, and all other measurable variables.

"LEGEND is a novel approach that could transform the way we use real-world evidence in healthcare," says co-author Patrick Ryan, PhD, adjunct assistant professor of biomedical informatics at Columbia. "Rather than inefficiently conducting bespoke analyses one-question-one-method-one-database-at-a-time, leaving us vulnerable to various threats to scientific validity, LEGEND provides a systematic framework that can reproducibly generate evidence by applying advanced analytics across a network of disparate databases for a wide array of exposures and outcomes."

"Not only does LEGEND offer a path to scale to the real needs of the health care community," Ryan added, "it also provides the complementary diagnostics to help us understand how much we can trust the evidence we've produced."

For further reference log on to:

https://doi.org/10.1186/s13063-019-3909-z

LEGEND HypertensionhydrochlorothiazideJAMAchlorthalidoneDiuretics
Source : JAMA Internal medicine
Dr. Kamal Kant Kohli
Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

Show Full Article
Next Story

Editorial

ABYSS Trial Finds Elevated BP, HR & Deleterious CV Outcomes After Beta blocker Withdrawal Post-MI: EuroPCR 2025 Update

ABYSS Trial Finds Elevated BP, HR & Deleterious CV Outcomes After Beta blocker Withdrawal Post-MI:...

Aspirin Use in Male Smokers Aged 40-45 Years with Hypertension: Identifying the Ideal Candidates

Aspirin Use in Male Smokers Aged 40-45 Years with Hypertension: Identifying the Ideal Candidates

National Consensus 2025 on Role of Bisoprolol Across CV Continuum in Women: Top 10 Takeaways

National Consensus 2025 on Role of Bisoprolol Across CV Continuum in Women: Top 10 Takeaways

Relevance of Pioglitazone in Indian T2DM Care Continuum

Relevance of Pioglitazone in Indian T2DM Care Continuum

Azmarda Outperforms Generic Sacubitril/Valsartan in HFrEF Management, says new study

Azmarda Outperforms Generic Sacubitril/Valsartan in HFrEF Management, says new study

View All

Journal Club Today

Study Unveils Molecular Links between Air Pollution and Negative Birth Outcomes

Study Unveils Molecular Links between Air Pollution and Negative Birth Outcomes

View All

Health News Today

Health Bulletin 06/June/2025

Health Bulletin 06/June/2025

View All
© 2022 All Rights Reserved.
Powered By: Hocalwire
X
We use cookies for analytics, advertising and to improve our site. You agree to our use of cookies by continuing to use our site. To know more, see our Cookie Policy and Cookie Settings.Ok