The effect of thiazide diuretics on coronary risk factors

Benzothiadiazine diuretics (thiazides) were introduced twenty years ago (Hollander and Wilkins, 1957), and remain the most commonly used type of antihypertensive drug. Their long term use alone provides smooth control of blood pressure in mild to moderate hypertensives (Beevers, Hamilton and Harpur, 1971), and they are also valuable as adjuvant therapy with other antihypertensive drugs. Whilst thiazides are virtually free of any clinical side effects, they do cause many biochemical changes, the significance of which is uncertain. Many of these biochemical abnormalities are possible risk factors for the development of coronary heart disease (C.H.D.), or other serious conditions. The magnitude and importance of these changes are discussed in this review.