What is the first-line treatment for hypertension in a young, otherwise healthy patient?

Thiazide diuretics are often considered the first-line treatment for hypertension in young, otherwise healthy patients. This choice is based on their effectiveness, safety profile, and the evidence supporting their use in managing hypertension across various age groups. Thiazide diuretics lower blood pressure by promoting renal excretion of sodium and water, which decreases blood volume and, subsequently, blood pressure.

In younger patients, non-pharmacologic measures such as lifestyle modifications (diet, exercise, weight management) are often encouraged as first steps, but if medication is needed, thiazide diuretics are frequently recommended due to their role in preventing cardiovascular disease in this demographic. Additionally, they have been shown to be beneficial in reducing hypertension-related complications and have a favorable effect on metabolic parameters compared to other antihypertensive medications.

While other options like ACE inhibitors, calcium channel blockers, and beta-blockers may also be effective in treating hypertension, thiazide diuretics hold a unique position for their initial use in young patients without comorbid conditions, as they directly address the underlying issue of volume overload without the need for additional considerations that other classes of drugs might necessitate.