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Chlorthalidone vs Hydrochlorothiazide and Kidney Outcomes in Patients With Hypertension: A Secondary Analysis of a Randomized Clinical Trial.
JAMA Netw Open
December 2024
Cooperative Studies Program Coordinating Center, VA Boston Healthcare System, Boston, Massachusetts.
Importance: Hypertension is a risk factor for the development and progression of chronic kidney disease (CKD). It is unclear whether different thiazide diuretics have a differential impact on kidney outcomes.
Objective: To compare kidney outcomes in patients with hypertension taking chlorthalidone and hydrochlorothiazide.
Characteristics of VA hospitals by participation status in a large pragmatic embedded clinical trial.
Contemp Clin Trials
January 2025
Cooperative Studies Program Coordinating Center, VA Boston Healthcare System, Boston, MA, USA; Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA. Electronic address:
Article Synopsis
- The Diuretic Comparison Project (DCP) was a pragmatic trial in the VA healthcare system that compared two diuretics, chlorthalidone and hydrochlorothiazide, to see which better prevents major cardiovascular events in hypertensive patients.
- The study analyzed data from participating and non-participating medical centers to determine factors influencing their decision to join, including socio-economic status and hospital performance metrics.
- Findings revealed that urban centers, those with higher incomes, and hospitals with prior research experience were more likely to participate, suggesting that improving engagement with lesser-involved facilities could enhance future recruitment for clinical trials.*
Thiazide and thiazide-like diuretics are associated with improved cardiovascular and renal outcomes in patients with chronic kidney disease.
Ann Acad Med Singap
October 2023
Department of Pediatrics, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Taiwan.
Introduction: Hypervolemia is a prevalent comorbidity of chronic kidney disease (CKD) patients. Thiazide diuretics (THZ) are the most common treatment for volume overload and hypertension (HTN). This study examines the association between THZ usage and clinical outcomes among CKD patients in a nationwide cohort.
View Article and Find Full Text PDFChlorthalidone vs Hydrochlorothiazide for Hypertension Treatment After Myocardial Infarction or Stroke: A Secondary Analysis of a Randomized Clinical Trial.
JAMA Netw Open
May 2024
Cooperative Studies Program Coordinating Center, VA Boston Healthcare System, Boston, Massachusetts.
Importance: Patients with prior myocardial infarction (MI) or stroke have a greater risk of recurrent cardiovascular (CV) events.
Objective: To evaluate the association of chlorthalidone (CTD) vs hydrochlorothiazide (HCTZ) with CV outcomes and noncancer deaths in participants with and without prior MI or stroke.
Design, Setting, And Participants: This was a prespecified secondary analysis of the Diuretic Comparison Project (DCP), a pragmatic randomized clinical trial conducted within 72 participating Veterans Affairs health care systems from June 2016 to June 2021, in which patients aged 65 years or older with hypertension taking HCTZ at baseline were randomized to continue HCTZ or switch to CTD at pharmacologically comparable doses.
Chlorthalidone vs Hydrochlorothiazide for Hypertension-CV Events: Did the Design Influence the Outcome?
J Assoc Physicians India
October 2023
Director, Apollo Hospitals, Hyderabad, Telangana, India.
The Diuretic Comparison Project (DCP)1 was a real world study planned to evaluate in a pragmatic manner whether Chlorthalidone (CTD), as compared with Hydrochlorothiazide (HCTZ), would reduce the risk of major nonfatal cardiovascular disease outcomes in elderly hypertensive participants (≥65 years) who were receiving HCTZ (25 or 50 mg) at baseline. This study being a real world study lacks the robustness of a randomized controlled trial. The principle limitation being unequal exposure of the two diuretics, prolonged unknown duration of exposure to HCTZ vs a short exposure to CTD (Median 2.
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