Diuretic Therapy for Hypertension and the Risk of Primary Cardiac Arrest

Unexpected findings from the Multiple Risk Factor Intervention Trial, a trial of the primary prevention of coronary heart disease, suggested that treating hypertension with high doses of thiazide diuretic drugs might increase the risk of sudden death from cardiac causes 1 – 4 . Meta-analyses of clinical trials evaluating the treatment of hypertensive patients with high doses of a thiazide suggest a reduction of 8 to 12 percent in mortality from coronary heart disease -- substantially less than the reduction of 20 to 25 percent predicted in epidemiologic studies 5 , 6 . In recent clinical trials, in contrast, the treatment of hypertensive patients . . .