On the basis of a meta-analysis of randomized studies assessing reductions in 24 h ambulatory blood pressure, investigators have concluded that hydrochlorothiazide is an inappropriate first-line drug for antihypertensive treatment. This conclusion has the potential to change current prescribing practice for patients with hypertension, but should meta-analyses be considered the ultimate level of evidence, particularly those based on a surrogate outcome?
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Acknowledgements
This manuscript has been prepared as one of the activities of the EC Network of Excellence InGenious HyperCare (contract LSHM-CT-2006-037,093). The author would like to thank Mrs D. Mihalich for secretarial help.
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Zanchetti, A. Meta-analyses: first-rank evidence or second-hand information?. Nat Rev Cardiol 8, 249–251 (2011). https://doi.org/10.1038/nrcardio.2011.39
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DOI: https://doi.org/10.1038/nrcardio.2011.39
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