With PostgreSQL 9.5 a new kind of index was introduced, block range index.

BRIN indexes are a fraction (2-5% ) of normal BTree indexes, and only store min/max range data for a set of data/blocks.

On a naturally time-ordered table ( history, history_uint, etc) these indexes are very efficient, and can serve almost all queries.

Except!

Unbounded Lastvalue (limit=0) or sorted such (Select itemid, clock from history where itemid=1, order by clock desc, limit 1 offset 0) , will require parsing the entire table to get the data.

WIth the default ZBX_HISTORY_PERIOD=86400, an partial index on history* tables that covers "clock > now()-86400". can be created, which will efficiently cover lookups that request data with a limit.

More writeup on this approach is done here:
https://www.modio.se/optimizing-disk-usage-of-zabbix-and-postgresql.html