| | Thiazides first-line for hypertension |
 | | Contrary to common opinion, in ALLHAT the thiazide was similar to the ACEI and CCB in preventing end-stage renal disease, and in a large subgroup of patients with diabetes (12,063) none of the pre-specified subgroup outcomes favored the ACEI or CCB as compared to the thiazide. |
 | | If you presently use a thiazide as your first choice in all patients with hypertension, the ALLHAT results confirm your practice, and most of your treated hypertensive patients receive a thiazide alone or as a part of combination therapy. |
 | | To start a new patient on a thiazide, begin with HCTZ or chlorthalidone 12.5 mg daily, and if there is an inadequate BP response after 1-2 months increase to a maximum dose of 25 mg daily. |
| www.ti.ubc.ca /pages/letter47.htm (1416 words) |