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Evid Based Med 5:10 doi:10.1136/ebm.5.1.10
  • Therapeutics

Review: low-dose thiazides are the most effective first-line drugs for hypertension

Effectiveness of first-line antihypertensive drugs for hypertension at up to 10 years*

Comparison Number of studies Outcomes Pooled RRR (95% CI)
*ACE = angiotensin-converting enzyme. Other abbreviations defined in glossary.
†Not pooled.
Thiazides v β-blockers 5 Withdrawals because of adverse effects 31% (24 to 37)
Low-dose thiazides v no treatment 5 Death 11% (1 to 19)
Stroke 34% (21 to 44)
Coronary artery disease 29% (16 to 40)
Cardiovascular events 32% (25 to 38)
High-dose thiazides v no treatment 11 Stroke 53% (39 to 63)
Cardiovascular events 28% (18 to 37)
Calcium-channel blockers v no treatment 1 Stroke 39% (13 to 57)†
Cardiovascular events 39% (13 to 43)†
RRI (CI)
ACE inhibitors v calcium-channel blockers 1 Withdrawals because of adverse effects 231% (119 to 400)†

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