Science Department, Tchaikapharma High Quality Medicines, Inc, 1 G.M. Dimitrov Blvd, 1172, Sofia, Bulgaria.
Department of Informatics, New Bulgarian University, 21 Montevideo Str, 1618, Sofia, Bulgaria.
J Hum Hypertens. 2019 Nov;33(11):766-774. doi: 10.1038/s41371-019-0255-2. Epub 2019 Oct 8.
Hypertension is a complex syndrome of multiple hemodynamic, neuroendocrine, and metabolic abnormalities. The goals of treatment in hypertension are to optimally control high blood pressure and to reduce associated cardiovascular morbidity and mortality using the most suitable therapy available. Hydrochlorothiazide (HCTZ) and chlorthalidone (CTLD) are with proven hypertensive effects. The topic of our meta-analysis is to compare the efficacy of HCTZ and CTLD therapy in patient with hypertension. A search of electronic databases PubMed, MEDLINE, Scopus, PsyInfo, eLIBRARY.ru was performed. We chose the random-effects method for the analysis and depicted the results as forest plots. Sensitivity analyses were performed in order to evaluate the degree of significance of each study. Of the 1289 identified sources, only nine trials directly compared HCTZ and CTLD and were included in the meta-analysis. Changes in SBP lead to WMD (95% CI) equal to -3.26 mmHg showing a slight but statistically significant prevalence of CTLD. Results from analyzed studies referring to DBP lead to WMD (95% CI) equal to -2.41 mmHg, which is also statistically significant. During our analysis, we found that there were not enough studies presenting enough data on the effect of CTLD and HCTZ on levels of serum potassium and serum sodium. Our meta-analysis has demonstrated a slight superiority for CTLD regarding blood pressure control. At the same time, the two medications do not show significant differences in their safety profile.
高血压是一种涉及多种血流动力学、神经内分泌和代谢异常的复杂综合征。高血压治疗的目标是通过使用最合适的治疗方法，最佳地控制高血压，并降低相关的心血管发病率和死亡率。氢氯噻嗪（HCTZ）和氯噻酮（CTLD）已被证明具有降压作用。我们的荟萃分析的主题是比较 HCTZ 和 CTLD 治疗高血压患者的疗效。对电子数据库 PubMed、MEDLINE、Scopus、PsyInfo、eLIBRARY.ru 进行了检索。我们选择了随机效应方法进行分析，并以森林图的形式展示结果。进行了敏感性分析，以评估每项研究的显著性程度。在确定的 1289 个来源中，只有 9 项试验直接比较了 HCTZ 和 CTLD，并被纳入荟萃分析。收缩压的变化导致 WMD（95%CI）等于-3.26mmHg，表明 CTLD 略有但具有统计学意义的优势。关于 DBP 的分析研究结果导致 WMD（95%CI）等于-2.41mmHg，这也具有统计学意义。在我们的分析中，我们发现没有足够的研究提供足够的数据来评估 CTLD 和 HCTZ 对血清钾和血清钠水平的影响。我们的荟萃分析表明，CTLD 在控制血压方面略有优势。同时，这两种药物在安全性方面没有显著差异。
