What is the first-line treatment for uncomplicated hypertension?

The first-line treatment for uncomplicated hypertension is thiazide diuretics. This choice is based on extensive clinical evidence that supports the effectiveness of thiazides in reducing blood pressure and their favorable outcomes in preventing cardiovascular events. Thiazide diuretics work by decreasing blood volume through renal excretion of sodium and water, which leads to a reduction in blood pressure.

In guidelines for managing hypertension, thiazide diuretics are often emphasized due to their role in long-term control of blood pressure and their cost-effectiveness. They have been shown to be particularly beneficial in older adults and in patients with isolated systolic hypertension.

While other classes of antihypertensive agents, such as beta-blockers, ACE inhibitors, and calcium channel blockers, have their place in treatment, they are generally considered for specific situations or in patients with additional comorbidities. For instance, beta-blockers may be preferable in patients with a history of heart disease, ACE inhibitors are especially useful in patients with heart failure or chronic kidney disease, and calcium channel blockers can be effective for certain patient populations. However, in the absence of other medical issues, thiazide diuretics are the recommended first-line option.