Heart beat: Water pills carry the day

Heart beat

Water pills carry the day

Diuretics, often called water pills, are one of the oldest and least expensive treatments for high blood pressure. And they remain one of the best.

Once brushed aside by newer medications, diuretics were thrust back into the spotlight by a blockbuster clinical trial known as ALLHAT. Chlorthalidone, a thiazide diuretic, was at least as good as a calcium-channel blocker (amlodipine) and an ACE inhibitor (lisinopril) at lowering blood pressure and reducing the risk for heart attack and heart-related death, and was better at preventing heart failure.

Despite the results, some doctors have been hesitant to prescribe a thiazide diuretic as a first-line treatment for high blood pressure. Some worried it wasn't a good choice for blacks; others feared that the benefits would be canceled out by a possible increase in diabetes.

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