An Observational and Comparative Study of Cardiovascular Drug: Chlorthalidone and Hydrochlorothiazide the First Line Drug Therapy of Hypertension
Abstract
Background: Hypertension is when the pressure in blood pressure vessels is too high. The heart has to work harder to pump blood. Hypertension also known as silent killer. There are 2 types of hypertensions each has a different cause. It causes complications such as heart attack or stroke heart failure, kidney problems, metabolic syndrome, etc. The risk of hypertension increases with age. Smoking and alcohol consumption also raises blood pressure.
Objective: The present investigation to observe and compare cardiovascular drug chlorthalidone versus hydrochlorothiazide the first line drug therapy of hypertension.
Methodologies: - The present observational study was conducted on 133 hypertension patients. This study was evaluated for the comparative study of two prescribed drugs that is, hydrochlorothiazide and chlorthalidone on hypertension patient the data was collected using suitable design data collection form. Patients having comorbidities conditions were excluded.
Results: Among 133 patients, 26% of total study population were females and 74% of total population were males. Majority of the patients were in the age group of 45-54 years accounting 33.83% of total study population and total 24.06% were alcoholic and chronic smoker. In this study we were included the patient on drug therapy of hydrochlorothiazide and chlorthalidone in which 61% were prescribed for hydrochlorothiazide treatment and 39% to a prescribed for chlorthalidone treatment and as per the data collected chlorthalidone lasts longer in the body than hydrochlorothiazide and it lasts up to 36 hours in the body. Chlorthalidone is 1 to 2 times as potent as hydrochlorothiazide but the quality of life of hydrochlorothiazide is better than chlorthalidone accounting with 61%
Conclusion: The present study revealed that the hypertension patients have poor quality of life and it is very important to improve their quality of life so that the patients can enjoy their day-to-day life. Experts prefer chlorthalidone and hydrochlorothiazide both works well but hydrochlorothiazide prescribe more often.
Keywords: Hypertension, blood pressure, chlorthalidone and hydrochlorothiazide
Keywords:
Hypertension, Blood Pressure, Chlorthalidone and HydrochlorothiazideDOI
https://doi.org/10.22270/jddt.v16i8.7907References
1. Patel A., Barman AK., Gupta A. Review Article on Hypertension DOI: 10.35629/7781-0604146152
2. Mogi, M., Maruhashi, T., Higashi, Y. et al. Update on Hypertension Research in 2021. Hypertens Res 45, 1276-1297 (2022). https://doi.org/10.1038/s41440-022-00967-4 PMid:35790879 PMCid:PMC9255494
3. Whelton PK, Carey RM, Aronow, WS, Casey DE, Collins KJ, Himmelfarb CD, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am CollCardiol. 2018;71(19):e127-e248. https://doi.org/10.1161/HYP.0000000000000076
4. Kuwabara M. Cardiovascular disease, and hypertension. Pulse (Basel). 2016; 3:242-52. 3-4 https://doi.org/10.1159/000443769 PMid:27195245 PMCid:PMC4865070
5. Deguire, Jason & Clarke, Janine & Rouleau, Kaitlyn & Roy, Joel & Bushnik, Tracey. (2019). Blood pressure and hypertension. Health reports. 30. 14-21. 10.25318/82-003-x201900200002.
6. Maruhashi T, Higashi Y. Current topic of vascular function in hypertension. Hypertens Res. 2023;46:630-7. https://doi.org/10.1038/s41440-022-01147-0 PMid:36604472 PMCid:PMC9813887
7. Paiva, Annelise M.G.a,∗; Gomes, Maria I.C.M.a,∗; Silva, Érica A.A.a; Feitosa, Audes D.M.b,c; Malachias, Marcus V.B.d; Sposito, Andrei C.e; Mota-Gomes, Marco A.a; Nadruz, Wilson Jre. Should arm positioning matter in the diagnosis of orthostatic hypotension and hypertension?. Journal of Hypertension 42(1):p 186-188, January 2024. | https://doi.org/10.1097/HJH.0000000000003571 PMid:38033257
8. Stergiou, George S.a; Mukkamala, Ramakrishnab; Avolio, Albertoc; Kyriakoulis, Konstantinos G.a; Mieke, Stephand; Murray, Alane; Parati, Gianfrancof,g; Schutte, Aletta E.h; Sharman, James E.i; Asmar, Rolandj; McManus, Richard J.k; Asayama, Keil; De La Sierra, Alejandrom; Head, Geoffreyn; Kario, Kazuomio; Kollias, Anastasiosa; Myers, Martinp; Niiranen, Teemuq,r; Ohkubo, Takayoshil; Wang, Jiguangs; Wuerzner, Grégoiret; O’Brien, Eoinu; Kreutz, Reinholdv; Palatini, Paolow. Cuffless blood pressure measuring devices: review and statement by the European Society of Hypertension Working Group on Blood Pressure Monitoring and Cardiovascular Variability. Journal of Hypertension 40(8):p 1449-1460, August 2022. | https://doi.org/10.1097/HJH.0000000000003224 PMid:35708294
9. Johnson J (2021) Review on High Blood Pressure Hematol Thrombo Dis 9:434.
10. Shakiba, E., Najafi, F., Pasdar, Y. et al. A prospective cohort study on the association between dietary fatty acids intake and risk of hypertension incident. Sci Rep 13, 21112 (2023). https://doi.org/10.1038/s41598-023-48256-5 PMid:38036572 PMCid:PMC10689772
11. Deguire, Jason & Clarke, Janine & Rouleau, Kaitlyn & Roy, Joel & Bushnik, Tracey. (2019). Blood pressure and hypertension. Health reports. 30. 14-21. 10.25318/82-003-x201900200002.
12. Agarwal R. Hydrochlorothiazide versus chlorthalidone: What is the difference. Circulation. 2022;146:1641-3. https://doi.org/10.1161/CIRCULATIONAHA.122.061029 PMid:36205128
13. Heidari, B., Avenatti, E. and Nasir, K., 2022. Pharmacotherapy for Essential Hypertension: A Brief Review. Methodist DeBakey Cardiovascular Journal, 18(5), p.5-16.DOI: https://doi.org/10.14797/mdcvj.1175 PMid:36561082 PMCid:PMC9733188
14. Armstrong C., Joint National Committee. JNC8 guidelines for the management of hypertension in adults. Am Fam Physician. 2014 Oct 01;90(7):503-4.
15. Messerli FH, Bangalore S. Antihypertensive efficacy of aliskiren: is hydrochlorothiazide an appropriate benchmark? Circulation. 2009 Jan 27;119(3):371-3. PMid:19171867 https://doi.org/10.1161/CIRCULATIONAHA.108.828897
16. Carey RM, Calhoun DA, Bakris GL, Brook RD, Daugherty SL, Dennison-Himmelfarb CR, Egan BM, Flack JM, Gidding SS, Judd E, Lackland DT, Laffer CL, Newton-Cheh C, Smith SM, Taler SJ, Textor SC, Turan TN, White WB., American Heart Association Professional/Public Education and Publications Committee of the Council on Hypertension; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; Council on Genomic and Precision Medicine; Council on Peripheral Vascular Disease; Council on Quality of Care and Outcomes Research; and Stroke Council. Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association. Hypertension. 2018 Nov;72(5):e53-e90. https://doi.org/10.1161/HYP.0000000000000084 PMid:30354828 PMCid:PMC6530990
17. Whelton PK, Carey RM, Aronow WS, Casey DE, Collins KJ, Dennison Himmelfarb C, DePalma SM, Gidding S, Jamerson KA, Jones DW, MacLaughlin EJ, Muntner P, Ovbiagele B, Smith SC, Spencer CC, Stafford RS, Taler SJ, Thomas RJ, Williams KA, Williamson JD, Wright JT. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2018 Jun;71(6):e13-e115. https://doi.org/10.1161/HYP.0000000000000065
18. Puttnam R, Davis BR, Pressel SL, Whelton PK, Cushman WC, Louis GT, Margolis KL, Oparil S, Williamson J, Ghosh A, Einhorn PT, Barzilay JI., Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) Collaborative Research Group. Association of 3 Different Antihypertensive Medications With Hip and Pelvic Fracture Risk in Older Adults: Secondary Analysis of a Randomized Clinical Trial. JAMA Intern Med. 2017 Jan 01;177(1):67-76. https://doi.org/10.1001/jamainternmed.2016.6821 PMid:27893045
19. Wright JT, Probstfield JL, Cushman WC, Pressel SL, Cutler JA, Davis BR, Einhorn PT, Rahman M, Whelton PK, Ford CE, Haywood LJ, Margolis KL, Oparil S, Black HR, Alderman MH., ALLHAT Collaborative Research Group. ALLHAT findings revisited in the context of subsequent analyses, other trials, and meta-analyses. Arch Intern Med. 2009 May 11;169(9):832-42. https://doi.org/10.1001/archinternmed.2009.60 PMid:19433694 PMCid:PMC2803011
20. Dahlöf B, Sever PS, Poulter NR, Wedel H, Beevers DG, Caulfield M, Collins R, Kjeldsen SE, Kristinsson A, McInnes GT, Mehlsen J, Nieminen M, O’Brien E, Ostergren J., ASCOT Investigators. Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentre randomised controlled trial. Lancet. 2005 Sep 10-16;366(9489):895-906. https://doi.org/10.1016/S0140-6736(05)67185-1 PMid:16154016
21. Weber MA, Jamerson K, Bakris GL, Weir MR, Zappe D, Zhang Y, Dahlof B, Velazquez EJ, Pitt B. Effects of body size and hypertension treatments on cardiovascular event rates: subanalysis of the ACCOMPLISH randomised controlled trial. Lancet. 2013 Feb 16;381(9866):537-45. https://doi.org/10.1016/S0140-6736(12)61343-9 PMid:23219284
22. ONTARGET Investigators. Yusuf S, Teo KK, Pogue J, Dyal L, Copland I, Schumacher H, Dagenais G, Sleight P, Anderson C. Telmisartan, ramipril, or both in patients at high risk for vascular events. N Engl J Med. 2008 Apr 10;358(15):1547-59.
23. Khan N, McAlister FA. Re-examining the efficacy of beta-blockers for the treatment of hypertension: a meta-analysis. CMAJ. 2006 Jun 06;174(12):1737-42. https://doi.org/10.1503/cmaj.060110 PMid:16754904 PMCid:PMC1471831
24. Thomopoulos C, Parati G, Zanchetti A. Effects of blood pressure-lowering treatment on cardiovascular outcomes and mortality: 14 - effects of different classes of antihypertensive drugs in older and younger patients: overview and meta-analysis. J Hypertens. 2018 Aug;36(8):1637-1647. https://doi.org/10.1097/HJH.0000000000001777 PMid:29847487
25. Lindholm LH, Carlberg B, Samuelsson O. Should beta blockers remain first choice in the treatment of primary hypertension? A meta-analysis. 2005 Oct 29-Nov 4Lancet. 366(9496):1545-53. https://doi.org/10.1016/S0140-6736(05)67573-3 PMid:16257341
26. Chapman N, Dobson J, Wilson S, Dahlöf B, Sever PS, Wedel H, Poulter NR., Anglo-Scandinavian Cardiac Outcomes Trial Investigators. Effect of spironolactone on blood pressure in subjects with resistant hypertension. Hypertension. 2007 Apr;49(4):839-45. https://doi.org/10.1161/01.HYP.0000259805.18468.8c PMid:17309946
27. Khosla N, Kalaitzidis R, Bakris GL. Predictors of hyperkalemia risk following hypertension control with aldosterone blockade. Am J Nephrol. 2009;30(5):418-24. https://doi.org/10.1159/000237742 PMid:19738369
28. Williams B, MacDonald TM, Morant S, Webb DJ, Sever P, McInnes G, Ford I, Cruickshank JK, Caulfield MJ, Salsbury J, Mackenzie I, Padmanabhan S, Brown MJ., British Hypertension Society’s PATHWAY Studies Group. Spironolactone versus placebo, bisoprolol, and doxazosin to determine the optimal treatment for drug-resistant hypertension (PATHWAY-2): a randomised, double-blind, crossover trial. Lancet. 2015 Nov 21;386(10008):2059-2068. https://doi.org/10.1016/S0140-6736(15)00257-3 PMid:26414968 PMCid:PMC4655321
29. Akbari P, Khorasani-Zadeh A. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Jan 23, 2023. Thiazide Diuretics.
30. Leung AA, Wright A, Pazo V, Karson A, Bates DW. Risk of thiazide-induced hyponatremia in patients with hypertension. Am J Med. 2011 Nov;124(11):1064-72. https://doi.org/10.1016/j.amjmed.2011.06.031 PMid:22017784
31. Carey RM, Calhoun DA, Bakris GL, Brook RD, Daugherty SL, Dennison-Himmelfarb CR, Egan BM, Flack JM, Gidding SS, Judd E, Lackland DT, Laffer CL, Newton-Cheh C, Smith SM, Taler SJ, TextorSC, Turan TN, White WB., American Heart Association Professional/Public Education and Publications Committee of the Council on Hypertension; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; Council on Genomic and Precision Medicine; Council on Peripheral Vascular Disease; Council on Quality of Care and Outcomes Research; and Stroke Council. Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association. Hypertension. 2018 Nov;72(5):e53-e90. PMCid:PMC6530990 https://doi.org/10.1161/HYP.0000000000000084 PMid:30354828
Published
Abstract Display: 60
PDF Downloads: 57
PDF Downloads: 21 How to Cite
Issue
Section
Copyright (c) 2026 Ishika Roy , Abhishek Prasad

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).

.