[Hypertension therapy--never without diuretics?]

Diuretics are highly effective and are valuable antihypertensives in modern high blood pressure therapy. As a monotherapy, diuretics should be preferably be used in elderly patients; in a combination therapy, in any case in a triple combination therapy, they should be used regardless of the patient's age. Disadvantages include risk for developing hypokalaemia, their diabetogenicity with unclear long-term prognosis and the usually limited treatment persistence. Diuretics are no longer the lowest-priced antihypertensives. For monotherapy and dual combination therapy, effective alternatives are available. The necessity for the use of diuretics cannot be rationalized either medically or economically.