Kumari U, Kaka M, Abbas F, Rai A, Kumari S, Wazir HU, Surani S. Comparative efficacy and safety of chlorthalidone vs hydrochlorothiazide in hypertension management: A systematic review and meta-analysis. World J Cardiol 2026; 18(2): 112956 [PMID: 41694035 DOI: 10.4330/wjc.v18.i2.112956]
Corresponding Author of This Article
Salim Surani, MD, Department of Medicine and Pharmacology, Texas A&M University, 40 Bizzell Street, College Station, TX 77843, United States. srsurani@hotmail.com
Research Domain of This Article
Medicine, General & Internal
Article-Type of This Article
Meta-Analysis
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Feb 26, 2026 (publication date) through Mar 11, 2026
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Journal Information of This Article
Publication Name
World Journal of Cardiology
ISSN
1949-8462
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Kumari U, Kaka M, Abbas F, Rai A, Kumari S, Wazir HU, Surani S. Comparative efficacy and safety of chlorthalidone vs hydrochlorothiazide in hypertension management: A systematic review and meta-analysis. World J Cardiol 2026; 18(2): 112956 [PMID: 41694035 DOI: 10.4330/wjc.v18.i2.112956]
Usha Kumari, Department of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States
Manaswini Kaka, Department of Medicine, AIMU School of Medicine, Gros Islet 99999, Saint Lucia
Fakhar Abbas, Department of Internal Medicine, HCA West Side Florida, Plantation, FL 33324, United States
Amar Rai, Department of Medicine, Pennsylvania Hospital, University of Pennsylvania, Philadelphia, PA 19107, United States
Sanjana Kumari, Department of Medicine, Dow University of Health Science, Karachi 74200, Sindh, Pakistan
Hakim Ullah Wazir, Department of Medicine, Lady Reading Hospital, Peshawar 25000, Khyber Pakhtunkhwa, Pakistan
Salim Surani, Department of Medicine and Pharmacology, Texas A&M University, College Station, TX 77843, United States
Author contributions: Kumari U contributed to the conceptualization, study design, literature screening, and data synthesis; Kumari U and Kumari S participated in data extraction; Kaka M, Abbas F, and Wazi HU drafted the manuscript; Rai A, Wazir HU, and Surani S reviewed and edited the manuscript; Kumari S contributed to reference management; Wazir HU and Surani S contributed to project administration; Surani S contributed to overall supervision. All authors have read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Corresponding author: Salim Surani, MD, Department of Medicine and Pharmacology, Texas A&M University, 40 Bizzell Street, College Station, TX 77843, United States. srsurani@hotmail.com
Received: August 11, 2025 Revised: October 1, 2025 Accepted: December 17, 2025 Published online: February 26, 2026 Processing time: 182 Days and 16 Hours
Core Tip
Core Tip: Hypertension is a leading cause of cardiovascular disease, chlorthalidone and hydrochlorothiazide are widely used treatments. This meta-analysis compared their efficacy and safety in adults with primary hypertension, including 11 studies published from 2005 to 2025. Chlorthalidone achieved greater reductions in both systolic blood pressure and diastolic blood pressure, as well as superior nocturnal control (P = 0.0002). Cardiovascular safety was similar, with a nonsignificant reduction in myocardial infarction risk for chlorthalidone and no difference in stroke or mortality, but hydrochlorothiazide had a lower risk of hypokalemia. The findings highlight that drug choice should be tailored to individual patient needs, balancing stronger blood pressure reduction from chlorthalidone against the lower hypokalemia risk of hydrochlorothiazide.
