The place of diuretics in preventing cardiovascular events.

Abstract:

:Low-dose diuretics are recommended for the initial choice of antihypertensive therapy in the 7th US Joint National Committee report and are accepted as an appropriate choice among other classes of drugs in the 2003 European Society of Hypertension guidelines. The rationales for the use of low-dose diuretics include the following: Renal dysfunction interfering with normal natriuresis is likely a fundamental defect in the pathogenesis of hypertension. Subtle renal insufficiency that interferes with sodium excretion is a common consequence of uncontrolled hypertension. Diuretic-based therapy has been clearly documented in placebo-controlled, randomized trials to reduce cardiovascular morbidity and mortality, particularly in the treatment of elderly hypertensives.In multiple comparative trials, diuretic-based therapy has been shown to provide equal cardiovascular protection to that provided by newer agents. Diuretics enhance the antihypertensive efficacy of all other classes of agents. As lower blood pressure goals of therapy have been found to be needed, diuretic enhancement of other agents' efficacy has become even more essential. With such low doses, side effects are minimal in degree and infrequent in appearance.

journal_name

J Hum Hypertens

authors

Kaplan NM

doi

10.1038/sj.jhh.1001798

subject

Has Abstract

pub_date

2004-12-01 00:00:00

pages

S29-32

eissn

0950-9240

issn

1476-5527

pii

1001798

journal_volume

18 Suppl 2

pub_type

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