Hypertension is a very common condition that is responsible for more than one of every eight premature deaths nationwide.
Diuretics are commonly prescribed to treat hypertension, and recent reports suggest that chlorthalidone may work better than hydrochlorothalizide.
Considering the potential for adverse effects, hydrochlorothiazide may be a safer treatment than chlorthalidone for elderly patients with uncomplicated hypertension.
Researchers reviewed health records for 29,873 patients aged 66 years or older who were newly treated with chlorthalidone (n = 10,384) or hydrochlorothiazide (n = 19,489) to compare the effectiveness and safety of the treatments.
For the primary outcome, a composite of death or hospitalization with myocardial infarction, heart failure, or stroke, there was no statistically significant difference between the two groups. However, patients taking chlorthalidone were three times more likely to be hospitalized for low potassium (hypokalemia) and about 1.7 times more likely to be hospitalized for low sodium (hyponatremia) than those prescribed hydrochlorothiazide.
The authors conclude that in the absence of hard data on the superiority of either chlorthalidone or hydrochlorothiazide, physicians who care for elderly patients should be mindful of the risk for electrolyte abnormalities in patients taking diuretics.