Low dose thiazide diuretic Is not available for prescribingBMJ 1994; 309 doi: https://doi.org/10.1136/bmj.309.6956.738a (Published 17 September 1994) Cite this as: BMJ 1994;309:738
- A Fraser,
- D J Webb
- Western General Hospitals Trust, Edinburgh EH4 2XU
- Peart-Rose Clinic, St Mary's Hospital, London W2 1NY Department of Epidemiology and Public Health, University College London Medical School, London WC1E 6EA
- Sir George E Clark Metabolic Unit, Royal Victoria Hospital, Belfast BT12 6BA.
EDITOR, — Because of their proved benefit in reducing cardiovascular morbidity and mortality and their low cost compared with the costs of other antihypertensive agents, thiazide diuretics have been widely recommended for the initial treatment of essential hypertension.¢RF 1-3¢ Indeed, the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure in the United States recently returned to recommending these agents, or ß blockers, as first line treatment in preference to newer drugs.2
Roy Harper and colleagues highlight the benefits of low doses of thiazide diuretic in essential hypertension.4 They show that, compared with 5 mg bendrofluazide, a dose of 1.25 mg has substantially less effect on serum potassium concentration and no effect on hepatic insulin action. This complements an earlier paper showing that low doses of bendrofluazide (1.25 mg and 2.5 mg) are effective in lowering blood pressure in patients with mild to moderate hypertension but are substantially less likely than higher doses to cause hypokalaemia, hyperglycaemia, or hyperuricaemia.5
Given this information, it might be expected that bendrofluazide 1.25 mg was …
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