Many people will require treatment with more than one antihypertensive drug to achieve blood pressure control. In the black hypertensive population, including those with diabetes, a calcium channel blocker or thiazide-type diuretic is recommended as initial therapy. In the general nonblack population, including those with diabetes, initial antihypertensive treatment should include a thiazide-type diuretic, calcium channel blocker (CCB), angiotensin-converting enzyme inhibitor (ACEI), or angiotensin receptor blocker (ARB).
Examples of thiazide and thiazide-like diuretics include:
- Chlorothiazide (Diuril) /oral or sodium injection/
- Chlorthalidone
- Hydrochlorothiazide (Microzide)
- Indapamide (most effective in the 80+ population (based on the Very Elderly Trial, HYVET), a randomized, double-blind placebo trial that enrolled 3,845 patients from 195 centers in Europe, China, Australia, and North Africa).
- Metolazone