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Thiazide diuretics are considered a first-line treatment for hypertension, particularly for the management of essential hypertension and for reducing cardiovascular risk. They work by promoting diuresis, which decreases blood volume and, consequently, lowers blood pressure. They also help with fluid balance and have a favorable effect on the cardiovascular system, influencing the function of vascular smooth muscle and the renal system.

Due to their effectiveness, low cost, and well-established safety profile, thiazide diuretics are often recommended as initial therapy in guidelines for treating high blood pressure. This foundation in pharmacological treatment helps clinicians manage hypertension effectively in many patients.

Other options, while also used in the treatment of hypertension, generally do not hold the same status as first-line agents for the broad population. For instance, calcium channel blockers and beta-blockers are often secondary options or may be used in specific populations based on comorbid conditions. Angiotensin II receptor blockers may likewise be considered in certain scenarios, particularly in patients with specific conditions like heart failure or those unable to tolerate ACE inhibitors. However, thiazide diuretics consistently remain a cornerstone in the initial approach to hypertension management.