5 April 2005

Low-dose thiazide diuretics should be used as first choice drug therapy for patients with hypertension, according to Dr Suzanne Hill and Professor Anthony Smith in the latest edition of Australian Prescriber.

While all five classes of anti-hypertensives are effective in reducing blood pressure, all health professionals should consider comparative safety, convenience, and costs when choosing a first line drug.

By considering each of these criteria, it becomes clear that for uncomplicated hypertension, low-dose thiazide diuretics should be used. If a patient doesn’t respond to this treatment, another drug may be added, while the emergence of adverse effects may necessitate a change of treatment altogether.

It is important for health professionals to select a treatment that works well, is safe and affordable for each patient. Because, after all, according to Prof Smith and Dr Hill from The University of Newcastle, “it is the reduction in blood pressure that counts and not the drug class used to reduce it".

Although newer antihypertensive drugs are heavily promoted by the pharmaceutical industry, older drugs work just as well. "Thiazide diuretics are effective, they are cheap, and we know a lot about their safety”, said Professor Smith and Dr Hill.

GPs and pharmacists can keep track of new antihypertensives and their place in therapy by attending one of National Prescribing Service Ltd’s (NPS) series of The Leading Edge: New Drugs Seminars being held across Australia over the coming months. For more information on attending a seminar visit www.nps.org.au/events.

Also in the April issue of Australian Prescriber is an article on combination asthma inhalers.

For the complete article visit the Australian Prescriber website www.australianprescriber.com.

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Australian Prescriber is an independent review providing critical commentary on therapeutic topics for health professionals. It is published by National Prescribing Service (NPS), an independent, non-profit organisation funded by the Australian Government Department of Health and Ageing. NPS works to improve the health of all Australians through Quality Use of Medicines.