Optimal dose of a thiazide diuretic

Abstract

In essential hypertension, 25 mg and 100 mg of chlorthalidone per day reduced blood pressure to a similar extent. The larger amount (100 mg per day of chlorthalidone) caused a greater reduction in extracellular volume and a larger rise in plasma renin activity and serum uric acid levels. Hypokalaemia was common with 100 mg per day of chlorthalidone, but was rarely seen in patients who took 25 mg per day, and neither dose caused total body potassium depletion. In the management of hypertension, 25 mg of chlorthalidone is the preferred dose as it produces most of the antihypertensive effects with only minor biochemical changes.