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Letters |18 June 2013

Chlorthalidone Versus Hydrochlorothiazide

James J. DiNicolantonio, PharmD; James H. O'Keefe, MD; Carl J. Lavie, MD

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Author, Article, and Disclosure Information
  • From Wegmans Pharmacy, Ithaca, New York; Mid America Heart Institute, University of Missouri, Kansas City, Missouri; and John Ochsner Heart and Vascular Institute, Ochsner Clinical School–The University of Queensland School of Medicine, New Orleans, Louisiana.

    Potential Conflicts of Interest: None disclosed.

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TO THE EDITOR:
Dhalla and colleagues (1) state, “As typically prescribed, chlorthalidone in older adults was not associated with fewer adverse cardiovascular events or deaths than hydrochlorothiazide. However, it was associated with a greater incidence of electrolyte abnormalities, particularly hypokalemia.” This observational cohort study is contrary to a meta-analysis of 108 clinical trials, which indicated that reductions in potassium levels were considered equivalent between chlorthalidone and HCTZ when they were used in the dose range between 12.5 and 25.0 mg (2). In addition, data from MRFIT (Multiple Risk Factor Intervention Trial) indicate that chlorthalidone significantly reduces CVEs compared with HCTZ (P < 0.001) (3).
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DiNicolantonio JJ, O'Keefe JH, Lavie CJ. Chlorthalidone Versus Hydrochlorothiazide. Ann Intern Med. ;158:920–921. doi: 10.7326/0003-4819-158-12-201306180-00015

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Published: Ann Intern Med. 2013;158(12):920-921.

DOI: 10.7326/0003-4819-158-12-201306180-00015

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