#Major side effect of ace inhibitors trial#

For this, they are used more for the management of HTN. They have less effect on heart contractility and conduction. ĬCBs divide into two groups: dihydropyridines and non-dihydropyridinesĭihydropyridines are more potent as vasodilators and are used more for HTN treatment. They can be used as the best alternative to thiazides when patients do not tolerate thiazides. ĬCBs have been shown to decrease all cardiovascular events other than heart failure, similar to thiazide diuretics. Same as thiazide-type diuretics, CCBs are recommended in JNC8 guidelines to be used as a first-line treatment alone or in combination with other antihypertensives in all patients with HTN regardless of age and race, except for patients with chronic kidney disease where ACE inhibitors or ARBs are the recommended first-line treatment. Compared with doxazosin mesylate and lisinopril, chlorthalidone was better in preventing cardiovascular disease, including strokes and incidence, and when compared with amlodipine, it was better in preventing heart failure.

#Major side effect of ace inhibitors trial#

The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) showed that chlorthalidone at 12.5 to 25 mg/day caused fewer cardiovascular complications than amlodipine and lisinopril.Ĭhlorthalidone is the first choice for older patients with osteoporosis, as it was associated with a lower incidence of pelvic fractures when compared to amlodipine and lisinopril. Switching to chlorthalidone from hydrochlorothiazide decreases systolic blood pressure by 7 to 8 mm Hg. Hydrochlorothiazide has a shorter effect during the day in a study that compared the office blood pressure reading with the 24-hour ambulatory blood pressure readings.

It demonstrated greater effectiveness than hydrochlorothiazide in lowering blood pressure when researchers monitored 24-hour ambulatory blood pressure. Studies show it to be the best diuretic to control blood pressure and prevent mortality and morbidity. Ĭhlorthalidone is the drug of choice to start as monotherapy for hypertension. They are better at decreasing the risk of cardiovascular disease compared to hydrochlorothiazide. Multiple studies have shown that thiazide-like diuretics (chlorthalidone and indapamide) in hypertension treatment are more potent than hydrochlorothiazide. Recommendations are to start them as first-line treatment for hypertension. Research shows that thiazide-type diuretics (chlorthalidone and indapamide) are superior in preventing cardiovascular disease at a lower cost. Treatment with hydrochlorothiazide as a single agent with a dose of 12.5 mg or 25 mg daily showed no evidence of decreasing morbidity or mortality. The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial ALLHAT study recommended thiazide diuretics as the first line of treatment for hypertension unless there are contraindications. Thiazide and thiazide-like diuretics are usually the first line of treatment for hypertension in JNC8 guidelines, the thiazide diuretics can be used as the first-line treatment for HTN (either alone or in combination with other antihypertensives) in all age groups regardless of race unless the patient has evidence of chronic kidney disease where angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker is indicated.

Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs)