Which drug class is considered the first-line therapy for hypertension?

Thiazide diuretics are considered the first-line therapy for hypertension due to their proven effectiveness in lowering blood pressure and their favorable evidence in long-term outcomes, particularly in the treatment of essential hypertension. They work by promoting the excretion of sodium and water through the kidneys, leading to a reduction in blood volume, which in turn lowers blood pressure.

Numerous large-scale studies have demonstrated that thiazide diuretics not only effectively lower blood pressure but also reduce the risk of cardiovascular events and hospitalizations associated with hypertension. They have a well-established safety profile and can be used in a wide range of patients, making them a preferred initial treatment choice.

While the other drug classes, such as calcium channel blockers, ACE inhibitors, and beta-blockers, are also effective for managing hypertension and may be preferred in specific clinical situations or patient populations, thiazide diuretics remain the foundational treatment for many patients starting therapy for high blood pressure.