A 60-year-old woman with no past medical history has an elevated blood pressure of 165/80 mm Hg on routine evaluation. Repeated measurements over the next month confirm the elevated pressure. Physical examination, routine blood count, and biochemistry are all normalFor patient with high blood pressure, select the most appropriate medication

Thiazides have been a cornerstone in most trials of antihypertensive therapy. Their adverse metabolic consequences include renal potassium loss leading to hypokalemia, hyperuricemia from uric acid retention, carbohydrate intolerance, and hyperlipidemia. The current U.S. Joint National Committee (JNC-7) guidelines suggest starting with thiazide diuretics because of their proven efficacy in lowering mortality and morbidity in large clinical trials. Other agents are considered if there are comorbidities such as diabetes or CAD.