What is considered the first-line therapy for chronic management of hypertension?

The first-line therapy for chronic management of hypertension typically includes diuretics and beta-blockers, particularly thiazide diuretics. Thiazide diuretics are favored due to their effectiveness in lowering blood pressure and their ability to reduce the risk of cardiovascular events, which is crucial in the management of hypertension.

Diuretics work by promoting the excretion of sodium and water, leading to a decrease in blood volume, which subsequently lowers blood pressure. They are often recommended as initial therapy, especially for patients who are older or have certain comorbidities, like heart failure.

Beta-blockers reduce heart rate and contractility, thereby lowering cardiac output and blood pressure. However, their use as monotherapy in uncomplicated hypertension has become less common compared to diuretics, especially in the absence of ischemic heart disease or heart failure.

While angiotensin-converting enzyme (ACE) inhibitors and calcium channel blockers are also effective and considered first-line options in specific populations or with certain underlying conditions, the combination of diuretics and beta-blockers provides a more comprehensive approach for many patients.

In summary, the combination of diuretics and beta-blockers is recognized for its established effectiveness in managing hypertension and reducing associated cardiovascular risks, making it the