Quality of Life and Antihypertensive Drug Therapy

Joel Handler, MD

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In This Article

Other Possible Adverse Effects

Thiazide-related hyperuricemia is dose related. In the Hypertension Detection and Follow-up Program (HDFP),[25] there were only 15 episodes of gout over 5 years in 3693 patients treated with chlorthalidone 25 mg to 100 mg (equivalent to HCTZ dosages in the 50 mg to 200 mg range). With low dosages of thiazides, it is unusual to precipitate gout.

In a meta-analysis that reviewed 11 randomized controlled trials with ß blockers, there was no worsening of claudication.[26] Many times post-MI patients have peripheral vascular disease, as well as claudication. Many investigators believe that peripheral arterial disease is an MI equivalent and that those patients should receive a ß blocker. The message is that if someone has peripheral arterial disease and claudication and needs a ß blocker, it should not be withheld.

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