…chlorthalidone, the study authors said.
“Until stronger evidence comes out to the contrary, I believe this study tips the scales toward hydrochlorothiazide for people taking a diuretic for high blood pressure,” said study co-author Dr. Harlan Krumholz, a professor of medicine at Yale University in New Haven, Conn.
Krumholz predicted treatment guidelines might shift from a generic endorsement of chlorthalidone to a more specific statement about the drug that seems safer.
He added that both drugs seem equally effective and are both inexpensive. “The good news is that the better choice is the most commonly prescribed diuretic for hypertension,” Krumholz said.
The findings should prompt patients to discuss treatment options with their doctors, he noted.
“The evidence is strong, but it is not a clinical trial, so there remains some uncertainty,” Krumholz said. “But until stronger evidence is out, this study represents some of the best information we have — and it favors hydrochlorothiazide.”
Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, said that because this study looked back at data, it can’t prove that one drug is better or safer than the other.
Fortunately, Fonarow said, a large randomized trial comparing these drugs is underway with a plan to enroll 13,500 people with high blood pressure. Results are expected in 2022.
In any case, the most important thing that people with high blood pressure can do is to keep their readings in check, Fonarow said.