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Thiazide diuretics are frequently recommended as a first-line therapy for hypertension, particularly in elderly patients. This is primarily because they effectively reduce blood pressure and have a well-established safety profile and tolerability among older adults. Thiazide diuretics work by inhibiting sodium reabsorption in the distal convoluted tubule of the kidneys, which increases the excretion of sodium and water, thereby leading to a decrease in blood volume and, consequently, lowering blood pressure.

In elderly patients, thiazide diuretics are often favored due to their effectiveness in managing hypertension and their ability to prevent complications associated with high blood pressure, such as stroke and heart failure. Furthermore, they can provide additional benefits, such as reducing the risk of osteoporosis-related fractures through their potential calcium-sparing effects.

While other classes of antihypertensive medications, such as ACE inhibitors, beta-blockers, and calcium channel blockers, can also be used in this population, thiazide diuretics remain a cornerstone in the management of hypertension for elderly patients due to their efficacy and favorable side effect profile in this demographic.