Chlorthalidone versus hydrochlorothiazide for the treatment of hypertension in older adults: a population-based cohort study

Annals of Internal Medicine
Irfan A DhallaDavid N Juurlink


Some evidence suggests that chlorthalidone may be superior to hydrochlorothiazide for the treatment of hypertension. To compare the effectiveness and safety of chlorthalidone and hydrochlorothiazide in older adults. Propensity score-matched observational cohort study with up to 5 years of follow-up. Ontario, Canada. All individuals aged 66 years or older who were newly treated with chlorthalidone or hydrochlorothiazide and were not hospitalized for heart failure, stroke, or myocardial infarction in the prior year were eligible for inclusion. Each chlorthalidone recipient was matched to up to 2 hydrochlorothiazide recipients on the basis of age, sex, year of treatment initiation, and propensity score. The primary outcome was a composite of death or hospitalization for heart failure, stroke, or myocardial infarction. Safety outcomes included hospitalization with hypokalemia or hyponatremia. A total of 29 873 patients were studied. During follow-up, chlorthalidone recipients (n = 10 384) experienced the primary outcome at a rate of 3.2 events per 100 person-years of follow-up, and hydrochlorothiazide recipients experienced 3.4 events per 100 person-years of follow-up (adjusted hazard ratio, 0.93 [95% CI, 0.81 to 1.06]). Patients t...Continue Reading


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Related Concepts

Antihypertensive Agents
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