Safety and Efficacy of Thiazide Diuretics in Hypertension

More than 30 years ago the prospective, randomized Systolic Hypertension in the Elderly Program (SHEP) study documented that treatment with a thiazide, specifically chlorthalidone, substantially reduced outcome in elderly patients with isolated systolic hypertension.1 Treatment was associated with a 36% reduction in stroke in 4736 patients, and a reduction in major cardiovascular events, by 55 events per 1000 patients over 5 years. In view of the above and other prospective studies in aggregate, we are puzzled by the conclusions of Ravioli et al,2 that taking of a thiazide was the strongest independent predictor of falls and syncope, and the authors ’ call for the thorough questioning of the use of thiazides in elderly patients who are prone to falls.
Source: The American Journal of Medicine - Category: General Medicine Authors: Tags: Letter Source Type: research