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

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 QUESTION: In patients with hypertension, which first-line drugs are effective for reducing death and cardiovascular events?

Data sources

Studies were identified by searching Medline (1966–97), the Cochrane Library (1998 issue 2), and references of previous meta-analyses (1980–97).

Study selection

Studies were selected if patients had systolic blood pressure ≥160 mm Hg or diastolic blood pressure ≥90 mm Hg; random allocation was used; a first-line antihypertensive drug was compared with another first-line drug or no treatment (including placebo); group baseline characteristics were reported; end points were defined; ≥1-year of follow-up was reported; and >70% of patients were receiving the study drug after 1 year. Studies were excluded if antihypertensive drugs …

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  • Sources of funding: British Columbia Ministry of Health and the University of British Columbia.

  • For correspondence: Dr J M Wright, Department of Pharmacology and Therapeutics, 2176 Health Sciences Mall, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada. FAX 604-822-0701.