Choice of Initial Treatment

In this article, Freis indicated that recent studies demonstrated that a patient's race should be an important consideration in the choice of initial treatment for hypertension. He noted that in white patients and those with prior myocardial infarctions, beta-blockers are more effective than diuretics. However, in black patients and others with congestive heart failure or renal failure, diuretics "are the drug of first choice." Freis also briefly discussed the possibility that thiazide induced hypokalemia and raised cholesterol levels, rejecting the former as poorly supported by research and the latter as only a minimal elevation.