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Which is better: Hydrochlorothiazide or Indapamide for hypertension?

Dr Chandra M Gulhati
Editor, MIMS,
New Delhi

Q: Which diuretic is better Hydrochlorothiazide or Indapamide in terms of efficacy and duration? Kindly guide me. My doctor says sustained release Indapamide is long acting whereas HCTZ has short action. I am tachycardic and get occasional ventricular ectopics, hence Atenolol 100 is given along with Amlodepine 10 mg, Losartan-100 and HCTZ 12.5. I am 45 years old and weigh 100 kg; otherwise normal reports of thyroid.

A:In the use of medicines, the issue is not which drug is better than the other but which one is more appropriate in a specific case. Hydrochlorothiazide is short acting while indapamide is long acting (1.5mg such as Indicontin Continus). In hypertension since 24-hour control and stable BP is desirable, many physicians prefer long-acting indapamide.