Which medication is considered the first choice for monotherapy of hypertension in older adults without comorbid conditions?

The thiazide diuretic is considered the first choice for monotherapy of hypertension in older adults without comorbid conditions due to its efficacy in lowering blood pressure and reducing the risk of cardiovascular events. Thiazide diuretics work primarily by promoting sodium and water excretion, which decreases blood volume and systemic vascular resistance, ultimately leading to lower blood pressure.

Additionally, thiazides have been well-studied in older populations and have shown favorable outcomes in terms of both blood pressure control and reduction of heart failure and stroke incidence. Their side effect profile is relatively benign, especially when compared to other classes of antihypertensives, making them a solid initial choice in this demographic.

While other options like alpha-blockers, vasodilators, and beta-blockers have their uses in specific situations or comorbidities, they are not typically the first-line treatments for uncomplicated hypertension in older adults. Alpha-blockers, for instance, tend to be less effective in lowering systolic blood pressure and may cause orthostatic hypotension, particularly concerning in older patients. Vasodilators can lead to significant reflex tachycardia and may require additional medications to mitigate this effect. Beta-blockers are usually reserved for individuals with certain conditions like coronary