Sigh. Hey Sam, I thought you were the guy that said just follow what the data says?
Now you go based on belief as well?
As you probably know, the "data" can be manipulated as well. And also every presentation of any data always has some kind of agenda or message behind it.
I've been out of family med for a while now. Today one of my cannabis patients said he is going to talk to his family doctor about his Hydrochlorothiazide for his HTN. He said it increases skin cancer! I had no idea about such a thing. But turns out he is right - because the data from some meta-analysis suggests an association. Gosh we have had HCTZ around for decades even before I started training to be Dr!
But oh well.....the data says so. Thank goodness I no longer manage HTN!
https://www.cfp.ca/content/66/2/116
Clinical question
Does hydrochlorothiazide (HCTZ) increase the risk of squamous cell carcinoma (SCC)?
Bottom line
Observational data suggest an association between HCTZ and the risk of SCC. Risk appears to consistently increase with dose and duration of use (eg, 5 years increases risk 3 to 4 times). Baseline incidence of SCC is less than 0.1% annually. The same risk has not been established with thiazidelike diuretics. The benefit of switching from HCTZ to another agent should be weighed against the risk of changing medications.