Wednesday, June 17, 2009

HCTZ a "paltry" antihypertensive ??!

HCTZ a "paltry" antihypertensive, with no effect on outcomes, new analysis suggests
June 15, 2009 | Lisa Nainggolan

Milan, Italy - Hydrochlorothiazide (HCTZ), the most commonly employed blood-pressure-lowering drug in the US, used at the usual doses prescribed—12.5 mg to 25 mg/per day—is a "paltry" antihypertensive, inferior to all other drug classes, and there is no published evidence that it reduces heart attack or stroke [1]. These are the controversial conclusions of a new pooled analysis of trials reported by Dr Franz Messerli (St Luke's-Roosevelt Hospital, New York, NY) during a late-breaking clinical-trial session here at the European Meeting on Hypertension 2009 this weekend.

Messerli stressed that his conclusions relate to 24-hour ambulatory BP monitoring and that, "when it comes to office BP, HCTZ isn't that bad. In the clinic, BP [with HCTZ] looks fairly decent, it's almost as good as other antihypertensive drugs, which means very simply that HCTZ lowers the BP fairly well during the day, when the patient sees the doctor in the office, but at night and early-morning hours, it loses its antihypertensive efficacy, so it creates a false sense of security for the patient and the doctor alike. /.../

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