thiazides: best monotherapy for htn??
A recent huge real-world study (LEGEND-HTN) compared the effectiveness and safety of the major first-line antihypertensive drug classes initiated as monotherapy, finding that thiazide or thiazide-like diuretics were better than ACE inhibitors, and that non-dihydropyridine calcium channel blockers fared the least well (see htn monotherapy hctz lancet2019 in dropbox, or doi.org/10.1016/ S0140-6736(19)32317-7). Details: -- the authors developed a comprehensive framework for real-world evidence from several large databases, including six administrative claims and three electronic health record databases: IBM Market Scan databases for US employer-based private payers, Medicare supplemental beneficiaries, and multi-state Medicaid; Japan and South Korea national health databases; and the Optimum Pan Therapeutic US health systems, IMS/IQVIA disease analyzer from Germany, and the Columbia University Medical Center electronic record databases -- 4.9 million patients were included;