Why are thiazide type diuretics one of the first line agents for stage I primary hypertensio

Why are thiazide type diuretics one of the first line agents for stage I primary hypertension?

Among the current classes of antihypertensive agents, thiazide and thiazide-type diuretics are both the oldest and most evidence-based, showing consistent decreases in morbidity and mortality in large, randomized, controlled trials. While low-dose (12.5 to 25 mg) hydrochlorothiazide (HCTZ) is the most frequently prescribed thiazide at present, landmark and more recent trials demonstrate the superiority of chlorthalidone (25 mg), indapamide (2.5 mg), or higher dose HCTZ (50 to 100 mg) on cardiovascular outcomes. Moreover, given the contributions of sodium to volume-mediated hypertension, particularly in the “salt-sensitive” elderly and African American populations, agents that promote natriuresis are particularly effective.

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