Comparison of Cardiovascular Outcomes Between Chlorthalidone and Hydrochlorothiazide in Hypertensive Patients

ABSTRACT Chlorthalidone (CLTD) and hydrochlorothiazide (HCTZ) are widely used thiazide diuretics for hypertension management. This study aimed to evaluate and compare the cardiovascular outcomes of patients treated with CLTD versus HCTZ. This multicenter, retrospective cohort study utilized data fro...

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Main Authors: Subin Lim, Ju Hyeon Kim, Seungmi Oh, Soon Jun Hong, Cheol Woong Yu, Hyung Joon Joo, Yong Hyun Kim, Eung Ju Kim
Format: Article
Language:English
Published: Wiley 2025-02-01
Series:The Journal of Clinical Hypertension
Subjects:
Online Access:https://doi.org/10.1111/jch.70000
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author Subin Lim
Ju Hyeon Kim
Seungmi Oh
Soon Jun Hong
Cheol Woong Yu
Hyung Joon Joo
Yong Hyun Kim
Eung Ju Kim
author_facet Subin Lim
Ju Hyeon Kim
Seungmi Oh
Soon Jun Hong
Cheol Woong Yu
Hyung Joon Joo
Yong Hyun Kim
Eung Ju Kim
author_sort Subin Lim
collection DOAJ
description ABSTRACT Chlorthalidone (CLTD) and hydrochlorothiazide (HCTZ) are widely used thiazide diuretics for hypertension management. This study aimed to evaluate and compare the cardiovascular outcomes of patients treated with CLTD versus HCTZ. This multicenter, retrospective cohort study utilized data from the Korea University Medical Center, derived from electronic health records. A total of 14 257 hypertensive patients treated with either CLTD (n = 1920) or HCTZ (n = 12 337) were identified. Patients were matched 1:1 using propensity scores, resulting in 1606 patients in each treatment group. Demographic and clinical characteristics, incidence of major adverse cardiovascular events (MACE), and safety profiles were analyzed. Baseline characteristics after propensity score matching were well balanced between the two groups. The average age was 61.8 ± 14.6 years for CLTD users, with 59.3% being male. The 3‐year MACE occurred in 1.2% of the CLTD group compared with 1.4% of the HCTZ group (hazard ratio 0.91, p = 0.77). For secondary outcomes, cardiovascular mortality was 0.2% in both groups (p = 0.92). Myocardial infarction occurred in 0.3% of CLTD users and 0.4% of HCTZ users (p = 0.65). The incidence of hypokalemia was 19.2% in the CLTD group versus 16.7% in the HCTZ group (p = 0.07). In conclusion, in hypertensive patients, CLTD and HCTZ showed comparable cardiovascular outcomes and safety profiles.
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spelling doaj-art-1e8de9f4bbaf4cfdb00b57ea4ee16bb02025-08-20T02:04:18ZengWileyThe Journal of Clinical Hypertension1524-61751751-71762025-02-01272n/an/a10.1111/jch.70000Comparison of Cardiovascular Outcomes Between Chlorthalidone and Hydrochlorothiazide in Hypertensive PatientsSubin Lim0Ju Hyeon Kim1Seungmi Oh2Soon Jun Hong3Cheol Woong Yu4Hyung Joon Joo5Yong Hyun Kim6Eung Ju Kim7Division of Cardiology Department of Internal Medicine Korea University Anam Hospital Seoul Republic of KoreaDivision of Cardiology Department of Internal Medicine Korea University Anam Hospital Seoul Republic of KoreaDepartment of Biostatistics Korea University College of Medicine Seoul Republic of KoreaDivision of Cardiology Department of Internal Medicine Korea University Anam Hospital Seoul Republic of KoreaDivision of Cardiology Department of Internal Medicine Korea University Anam Hospital Seoul Republic of KoreaDivision of Cardiology Department of Internal Medicine Korea University Anam Hospital Seoul Republic of KoreaDivision of Cardiology Department of Internal Medicine Korea University Ansan Hospital Ansan Republic of KoreaDivision of Cardiology Department of Internal Medicine Korea University Guro Hospital Seoul Republic of KoreaABSTRACT Chlorthalidone (CLTD) and hydrochlorothiazide (HCTZ) are widely used thiazide diuretics for hypertension management. This study aimed to evaluate and compare the cardiovascular outcomes of patients treated with CLTD versus HCTZ. This multicenter, retrospective cohort study utilized data from the Korea University Medical Center, derived from electronic health records. A total of 14 257 hypertensive patients treated with either CLTD (n = 1920) or HCTZ (n = 12 337) were identified. Patients were matched 1:1 using propensity scores, resulting in 1606 patients in each treatment group. Demographic and clinical characteristics, incidence of major adverse cardiovascular events (MACE), and safety profiles were analyzed. Baseline characteristics after propensity score matching were well balanced between the two groups. The average age was 61.8 ± 14.6 years for CLTD users, with 59.3% being male. The 3‐year MACE occurred in 1.2% of the CLTD group compared with 1.4% of the HCTZ group (hazard ratio 0.91, p = 0.77). For secondary outcomes, cardiovascular mortality was 0.2% in both groups (p = 0.92). Myocardial infarction occurred in 0.3% of CLTD users and 0.4% of HCTZ users (p = 0.65). The incidence of hypokalemia was 19.2% in the CLTD group versus 16.7% in the HCTZ group (p = 0.07). In conclusion, in hypertensive patients, CLTD and HCTZ showed comparable cardiovascular outcomes and safety profiles.https://doi.org/10.1111/jch.70000blood pressurechlorthalidonehydrochlorothiazidehypertensionmortalitymyocardial infarction
spellingShingle Subin Lim
Ju Hyeon Kim
Seungmi Oh
Soon Jun Hong
Cheol Woong Yu
Hyung Joon Joo
Yong Hyun Kim
Eung Ju Kim
Comparison of Cardiovascular Outcomes Between Chlorthalidone and Hydrochlorothiazide in Hypertensive Patients
The Journal of Clinical Hypertension
blood pressure
chlorthalidone
hydrochlorothiazide
hypertension
mortality
myocardial infarction
title Comparison of Cardiovascular Outcomes Between Chlorthalidone and Hydrochlorothiazide in Hypertensive Patients
title_full Comparison of Cardiovascular Outcomes Between Chlorthalidone and Hydrochlorothiazide in Hypertensive Patients
title_fullStr Comparison of Cardiovascular Outcomes Between Chlorthalidone and Hydrochlorothiazide in Hypertensive Patients
title_full_unstemmed Comparison of Cardiovascular Outcomes Between Chlorthalidone and Hydrochlorothiazide in Hypertensive Patients
title_short Comparison of Cardiovascular Outcomes Between Chlorthalidone and Hydrochlorothiazide in Hypertensive Patients
title_sort comparison of cardiovascular outcomes between chlorthalidone and hydrochlorothiazide in hypertensive patients
topic blood pressure
chlorthalidone
hydrochlorothiazide
hypertension
mortality
myocardial infarction
url https://doi.org/10.1111/jch.70000
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