A recent study conducted by scientists from Columbia University has challenged current guidelines recommending chlorthalidone as the preferred diuretic for managing high blood pressure.
The research suggests that chlorthalidone may lead to more serious side effects compared to hydrochlorothiazide, which is equally effective in lowering blood pressure.
Chlorthalidone and hydrochlorothiazide are diuretics commonly prescribed to reduce high blood pressure. They work by helping the body eliminate excess salt and water. Current guidelines favor chlorthalidone as the primary diuretic for hypertension treatment.
The researchers analyzed data spanning 17 years, involving over 730,000 individuals undergoing treatment for high blood pressure.
Chlorthalidone and hydrochlorothiazide were found to be equally effective in preventing heart attacks, hospitalizations due to heart failure, and strokes.
Patients taking chlorthalidone faced a nearly threefold higher risk of experiencing critically low levels of potassium and an increased likelihood of other electrolyte imbalances and kidney issues when compared to those on hydrochlorothiazide.
These side effects can result in abnormal heart rhythms, hyponatremia (low sodium levels) leading to confusion, kidney problems, and an elevated risk of type 2 diabetes.
Approximately 6.3% of patients on chlorthalidone developed hypokalemia (low blood potassium), while only 1.9% of those on hydrochlorothiazide experienced this condition.
Even when chlorthalidone was administered at lower doses than hydrochlorothiazide, rates of hypokalemia remained higher.
The study questions the choice of chlorthalidone as the preferred diuretic for managing high blood pressure, given the significantly higher risk of serious side effects such as low potassium levels and electrolyte imbalances.
Healthcare professionals prescribing chlorthalidone should closely monitor patients for these adverse effects. It is important to note that this study is not the first to identify side effects associated with chlorthalidone.
A previous observational study had also raised concerns about electrolyte imbalances associated with this diuretic.
Ultimately, the findings underscore the importance of ongoing research to guide the selection of the most suitable medications for individuals with hypertension, prioritizing both effectiveness and safety.
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