A post-hoc analysis published in the ‘Journal of Clinical Hypertension’ found that chlorthalidone failed as monotherapy when compared to amlodipine monotherapy for treatment of hypertension through systolic blood pressure intervention. The study analyzed data of 496 participants to evaluate chlorthalidone monotherapy and amlodipine monotherapy in terms of systolic blood pressure responses, adverse events and monotherapy failure rates.

The key findings were as follows:

• Chlorthalidone was associated with a higher monotherapy failure rate than amlodipine in the standard treatment group.
• No significant differences in adverse events between both chlorthalidone and amlodipine monotherapies.
• More participants on chlorthalidone monotherapy failed despite having systolic blood pressure (SPB) below the 140 mmHg cut off.
• Higher reduction of SBP with amlodipine monotherapy at the third visit.

In conclusion, chlorthalidone is more likely to fail as monotherapy than amlodipine. Optimizing monotherapy drug selection would help in population level control of hypertension.