The diuretic comparison project is a large, well done, pragmatic trial, that puts to rest the debate of HCTZ versus chlorthalidone. Listen to the Filtrate wrestle with their own cognitive dissonance.

The Filtrate:

Joel Topf

Swapnil Hiremath

Josh Waitzman

Jordy Cohen

With Special Guest:

Areef ishani lead author and Chief of Medicine VA Minneapolis

Editor:

Nayan Arora

Show Notes:

MRFIT switches diuretics and finds better outcomes.

Swapnil shows how many studies he is familiar with by spewing out a string of them.

Chlorthalidone wins: ALLHAT, MRFIT, SPRINT, HYVET, CLICK (not mentioned by Swap but by Jordy later)

HCTZ loses: HOPE3, ACCOMPLISH

Diuretic half-lifes NEJM review

Edarbyclor: Azilsartan and Chlorthalidone $240/month as per GoodRx

Nice mention of late study originator Frank Lederle. Please see his article in Annals about his diagnosis of pancreatic cancer. Moving.

Network analysis of HCTZ vs chlorthalidone

Antihypertensive efficacy of hydrochlorothiazide vs chlorthalidone combined with azilsartan medoxomil by George Bakris

Synopsis of the 2020 U.S. Department of Veterans Affairs/U.S. Department of Defense Clinical Practice Guideline: The Diagnosis and Management of Hypertension in the Primary Care Setting (Annals of Internal Medicine)

Testing for Primary Aldosteronism and Mineralocorticoid Receptor Antagonist Use Among U.S. Veterans: A Retrospective Cohort Study by Jordy Cohen

Study showing better risk reward ratio of low dose than high dose thiazide diuretics. Treatment of hypertension in the elderly: I. Blood pressure and clinical changes. Results of a Department of Veterans Affairs Cooperative Study.