Should we switch from bendrofluazide to chlorthalidone as the initial treatment for hypertension? A review of the available medication.

Show simple item record Arroll, Bruce en Wallace, Henry en 2018-10-16T23:15:46Z en 2017-06 en
dc.identifier.issn 1172-6164 en
dc.identifier.uri en
dc.description.abstract INTRODUCTION Thiazide diuretics are commonly prescribed in the treatment of hypertension. However, thiazide diuretics may not all be equal in their ability to reduce cardiovascular disease outcomes. AIM To determine if bendroflumethiazide/bendrofluazide, the most commonly used diuretic for hypertension in New Zealand, is as effective as other diuretics in terms of cardiovascular disease outcomes. METHODS Using recent reviews of thiazide-like (chlorthalidone or indapamide) and thiazide-type diuretics (hydrochlorothiazide and bendrofluazide) and a separate search of bendrofluazide, data on cardiovascular disease outcomes was extracted. RESULTS Nineteen relevant papers with 21 comparisons were found. All thiazide-based diuretics have been reported in at least one trial showing them to be more effective than placebo for cardiovascular disease outcomes, with the exception of chlorothiazide. There were no comparisons of bendrofluazide alone with other medications, but there were two studies with either bendrofluazide or hydrochlorothiazide compared with β-blockers; however, the pooled relative risk (RR) was not significant (RR = 1.10 (95% CI, 0.84-1.43)). For chlorthalidone, there were four comparisons with other medications, and the summary RR was statistically significant for cardiovascular disease outcomes (RR = 0.91 (95% CI, 0.85-0.98)). Chlorthalidone was significantly more effective for some cardiovascular disease outcomes when compared with doxazosin, amlodipine and lisinopril. CONCLUSIONS All thiazide-based medicines available in New Zealand are effective in terms of cardiovascular disease outcomes compared with placebo when used for treating hypertension, with the exception of chlorothiazide. Of the diuretics available in New Zealand for hypertension, only chlorthalidone has been shown to be more effective than other blood pressure-lowering medicines. It may be time to change from using bendrofluazide and start using chlorthalidone as a treatment for hypertension. en
dc.format.medium Print en
dc.language eng en
dc.relation.ispartofseries Journal of primary health care en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. Details obtained from en
dc.rights.uri en
dc.rights.uri en
dc.subject Humans en
dc.subject Hypertension en
dc.subject Chlorthalidone en
dc.subject Bendroflumethiazide en
dc.subject Antihypertensive Agents en
dc.subject Drug Substitution en
dc.title Should we switch from bendrofluazide to chlorthalidone as the initial treatment for hypertension? A review of the available medication. en
dc.type Journal Article en
dc.identifier.doi 10.1071/hc16038 en
pubs.issue 2 en
pubs.begin-page 105 en
pubs.volume 9 en
dc.rights.holder Copyright: Royal New Zealand College of General Practitioners en
pubs.end-page 113 en
pubs.publication-status Published en
dc.rights.accessrights en
pubs.subtype Review en
pubs.subtype Journal Article en
pubs.elements-id 640622 en Medical and Health Sciences en Population Health en Gen.Practice& Primary Hlthcare en
dc.identifier.eissn 1172-6156 en
pubs.record-created-at-source-date 2018-03-14 en
pubs.dimensions-id 29530222 en

Files in this item

Find Full text

This item appears in the following Collection(s)

Show simple item record


Search ResearchSpace