Water Wars: Dueling Diuretics – Chlorthalidone vs. Hydrochlorothiazide for Cardiovascular Event Reduction

Authors:
Brian Terrell, PharmD, BCACP
Eric J MacLaughlin, PharmD, BCPS

Reviewers:
Michelle Fravel, PharmD, BCPS
Kathryn (Katy) Pincus, PharmD, BCPS, BCACP

Citation:
Ishani A, Cushman WC, Leatherman SM, et al. Chlorthalidone vs. hydrochlorothiazide for hypertension-cardiovascular events. N Engl J Med. 2022;387(26):2401-2410.

The Problem

Approximately half of adults 20 years and older in the U.S. have hypertension, and it is a major cause of cardiovascular disease (CVD).¹ Thiazide diuretics are a first-line treatment for patients with high blood pressure (BP), either as monotherapy or, more often, in combination with other first-line agents,² but which one should clinicians use?