The primary goal of treatment of the patient with high blood pressure is to achieve the maximum reduction in the total risk of cardiovascular morbidity and mortality. Low-dose diuretics have been reaffirmed as evidence-based first-line therapy in a broad spectrum of patients with hypertension, especially the elderly. Decisions about the management of patients with hypertension should not be based on the level of blood pressure alone, but also on the presence of other risk factors, target-organ damage and cardiovascular disease. Recent guidelines stress the importance of using lower dosages and therapies that provide 24-hour blood pressure control with once-daily administration. Sustained release formulations offer several potential advantages in comparison to immediate release formulations. These include an improved plasma concentration-time profile and an adequately high trough:peak ratio which may therefore provide more consistent 24-hour BP reduction, with attenuation of early morning blood pressure surges and maximal target organ protection. The recently developed sustained release formulation of indapamide allows use of a lower daily dosage of the drug, thereby improving its efficacy:safety ratio in comparison with immediate release formulations. Clinical studies have confirmed the efficacy of indapamide SR 1.5 mg daily in lowering elevated blood pressure. Indapamide SR 1.5 mg shows an improved efficacy-tolerability profile, with excellent 24-hour effects on blood pressure and important properties with regard to left ventricular hypertrophy.