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Diuretics are just as effective as calcium channel blockers and ACE inhibitors in patients with diabetes, an analysis of the landmark ALLHAT trial concludes.

The researchers said treatment should be initiated with diuretics because they were the cheapest option with the fewest side-effects.

The study of 32,512 adults with hypertension and diabetes, in July's Archives of Internal Medicine, found choice of first-line treatment did not affect rates of fatal CHD or non-fatal myocardial infarction.

But Dr Eugene Hughes, a GP on the Isle of Wight and Primary Care Diabetes Society member, said the results would just add to GPs' confusion. He said: 'There's a lot of conflicting evidence and advice. My personal view is that the evidence supports the superiority of ACE inhibitors.'

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