What do systematic reviews say?

First‐line thiazides vs calcium channel blockers

First‐line thiazides may leads to lower withdrawals due to adverse effects Duration: 1 to 5 years compared with first‐line calcium channel blockers (low certainty).

• First‐line diuretics versus other classes of antihypertensive drugs for hypertension 2023 · Cochrane Headline outcomes only
  RR 0.81 [0.75, 0.88]
  7 studies · 33908 participants
  Low

First‐line thiazides vs ACE inhibitor

First‐line thiazides probably leads to lower withdrawals due to adverse effects Duration: 1 to 5 years compared with first‐line ACE inhibitors (moderate certainty).

• First‐line diuretics versus other classes of antihypertensive drugs for hypertension 2023 · Cochrane Headline outcomes only
  RR 0.73 [0.64, 0.84]
  3 studies · 25254 participants
  Moderate

First‐line thiazides vs alpha‐blocker

First‐line thiazides may leads to lower withdrawals due to adverse effects Duration: 1 to 3.2 years compared with first‐line alpha‐blockers (low certainty).

• First‐line diuretics versus other classes of antihypertensive drugs for hypertension 2023 · Cochrane Headline outcomes only
  RR 0.7 [0.54, 0.89]
  3 studies · 24772 participants
  Low

First‐line thiazides vs beta‐blocker

• First‐line diuretics versus other classes of antihypertensive drugs for hypertension 2023 · Cochrane Headline outcomes only
  no estimate extracted
  5 studies · 18501 participants
  Moderate