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J Clin Hypertens (Greenwich). 2015 Nov;17(11):848-54. doi: 10.1111/jch.12622. Epub 2015 Jul 20.

Comparison of the Effect of Thiazide Diuretics and Other Antihypertensive Drugs on Central Blood Pressure: Cross-Sectional Analysis Among Nondiabetic Patients.

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Division of Clinical Epidemiology, McGill University, Montreal, QC, Canada.
Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.
Division of Experimental Medicine, McGill University, Montreal, QC, Canada.
Division of General Internal Medicine, McGill University, Montreal, QC, Canada.
Department of Public Health Sciences, Queen's University, Kingston, ON, Canada.


Thiazide diuretics (TDs) are a cost-effective first-line therapy for uncomplicated hypertension; however, they are less prescribed than other options. The authors aimed to assess the noninferiority of TDs relative to different classes of antihypertensive medications in relation to central blood pressure. Cross-sectional data from the Quebec CARTaGENE project was used. Nondiabetic hypertensive participants on monotherapy for hypertension were studied. Separate adjusted models were constructed to establish noninferiority of TDs to non-TD antihypertensive medications for central blood pressure measurements. Models included a set of potential confounders. Of the 1194 hypertensive participants, 7.4% were taking TDs. We found that TDs were comparable with non-TD antihypertensive medications for central systolic blood pressure (adjusted regression coefficient, 0.45; 95% confidence interval, -1.61 to 2.50). No differences in other central measurements were noted. The results provide additional support that TDs are at least as effective as other first-line medications for treating uncomplicated hypertension.

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