THURSDAY, Nov. 26 (HealthDay News) -- Thiazide diuretics, commonly regarded by physicians as the diuretics of choice for long-term antihypertensive therapy, are the focus of a review article in the Nov. 26 issue of the New England Journal of Medicine.

Michael E. Ernst, of the University of Iowa in Iowa City, and Marvin Moser, M.D., of Yale University School of Medicine in New Haven, Conn., write that thiazides lead to an average reduction in systolic blood pressure of 10 to 15 mm Hg; however, only roughly one-third of Americans who are eligible for thiazide therapy receive it.

Thiazides may be particularly useful in treating hypertension in older patients and African-Americans, the authors write. They increase the effect of other antihypertensives when used in combination. Meta-analyses and systematic reviews have found that thiazide-based therapy can reduce the relative rate of heart failure by up to 49 percent, stroke by up to 38 percent, coronary heart disease by up to 21 percent, and all-cause mortality by about 10 percent.

"Diuretics are a heterogeneous class of antihypertensive medications that have long demonstrated effectiveness in reducing blood pressure and the risk of cardiovascular events. With proper attention to appropriate selection, dosing, and monitoring, diuretic-based regimens can greatly improve the ability to achieve blood-pressure goals," the authors conclude.

The authors reported financial relationships with Takeda Pharmaceuticals and GlaxoSmithKline.

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