Article: Antihypertensive therapy: beta-blockers and diuretics--why do physicians not always follow guidelines?

The most recent reports of the Joint National Committee (JNC VI) and the World Health Organization recommend beta-blockers and diuretics as first-line therapy for uncomplicated essential hypertension (1, 2). Similar recommendations have been issued over the past few years by many authoritative sources and influential journals. These recommendations were supposedly based on multiple prospective randomized trials attesting that only beta-blockers and diuretics, both in monotherapy and in combination, reduced morbidity and mortality in hypertension.

Ever since the Veterans Administration study in the 1970s (3), multiple and prospective randomized trials have ...

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