Vidcast:  https://youtu.be/_BuvLprMqjg   When blood pressures first rise, guidelines tell doctors to prescribe chlorthalidone.  A just published multi-site study from Columbia, Cornell, Yale, and UCLA warns that drug is not the safest choice.   Comparing the outcomes of chlorthalidone with the more traditional anti-hypertensive hydrochlorthiazide in more than 730,000 treated patients, both drugs prevent heart attacks, heart failure, and stroke equally well.   But chlorthalidone has nasty side effects.  It increases the incidence of kidney failure by up to 37%, diabetes by 21%, sodium depletion by 31%, and critical potassium depletion more than 250%.   The investigators warn against routine use of chlorthalidone.  If you are taking it, speak with your doctors about an alternative.    Hripcsak G, Suchard MA, Shea S, et al. Comparison of Cardiovascular and Safety Outcomes of Chlorthalidone vs Hydrochlorothiazide to Treat Hypertension. JAMA Intern Med. Published online February 17, 2020. doi:10.1001/jamainternmed.2019.7454   #hypertension #chlorthalidone #hydrochlorthiazide #kidneyfailure #electrolytes