Thiazide利尿劑能有效的控制血壓，從而達到減少心血管疾病及死亡率的效果。因此JNC7建議，除了強制適應症（compelling indication）外，thiazide利尿劑應被當作降血壓的首選藥物。在龐大的高血壓藥物支出費用的壓力下，我們都希望能以低價位的thiazide利尿劑來取代高價位的calcium channel blockers（CCBs）或angiotensin-converting enzyme inhibitor（ACEIs）；雖然臨床實驗証實低劑量的thiazide利尿劑引起代謝性異常的機率不大，但亦不能被忽略。本文是透過臨床文獻的討論，了解thiazide利尿劑在高血壓治療上的定位，同時讓讀者了解thiazide利尿劑本身的特性如藥物的副作用及其發生時間，該如何適當的預防及篩選病患，以求安全有效的使用此低價位的藥物。

Use of thiazide diuretics in hypertension could effectively reduce cardiovascular diseases and mortality. This is why JNC7 suggested that thiazide diuretics should be used as initial therapy for most patients with hypertension except those with compelling indications. Under the stress of the large expense in antihypertensive agents, use of thiazide diuretics instead of costly calcium channel blockers (CCBs) and angiotensin-converting enzyme inhibitor (ACEIs) should be considered to reduce prescription costs. Although many studies confirmed that low dose thiazide diuretic-induced metabolic effects are minimal, it still cannot be neglected. This article helps us make sure the efficacy of thiazide diuretics in hypertension through clinical trial discussion and lead us see through the characteristics of thiazide diuretics, how to prevent its adverse effect and how to screen patients as a candidate to use the costly effective thiazide diuretics.