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Medical News and Perspectives
July 4, 2007

Experts Argue Not All Diuretics the Same

JAMA. 2007;298(1):31. doi:10.1001/jama.298.1.31

Chicago—While a thiazide-type diuretic is the favored initial medical treatment option for patients with uncomplicated hypertension, current treatment guidelines do not specify which drug from this class is preferred. But some hypertension experts argue that despite the greater reductions in blood pressure that chlorthalidone provides compared with the top-selling thiazide diuretic, hydrochlorothiazide, it is underused in practice.

Dominic A. Sica, MD, professor of medicine and pharmacology at Virginia Commonwealth University, in Richmond, said physicians need to realize that chlorthalidone produces better results than hydrochlorothiazide. Hydrochlorothiazide is the diuretic component in most combination drugs for hypertension treatment, which may explain why physicians are likely to be more aware of it than they are of chlorthalidone, which is more often prescribed as a stand-alone drug.

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