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Thiazide diuretics are one of the cornerstones of drug therapy for hypertension. They are effective and inexpensive, but they can cause substantial metabolic side effects. McVeigh and co-workers sought to determine the lowest dose of cyclopenthiazide (the most commonly prescribed thiazide in Great Britain) that would exhibit antihypertensive activity without causing adverse biochemical effects.
The authors randomized 53 patients with mild hypertension (diastolic blood pressure between 90 and 110 mm Hg) to receive one of four treatments daily for eight weeks: 50, 125, or 500 micrograms of cyclopenthiazide, or placebo. Blood-pressure readings were taken by the same observer every two weeks in the patients' homes. Monthly laboratory tests enabl…