Vol 9, No 6 (2005)
Review paper
Published online: 2005-12-13
Diuretics in antihypertensive treatment - new facts, old concerns. Is it time for a right choice?
Urszula Brzezinska, Andrzej Tykarski
Nadciśnienie tętnicze 2005;9(6):474-488.
Vol 9, No 6 (2005)
REVIEV
Published online: 2005-12-13
Abstract
Diuretics are well-established antihypertensive agents. The
recent American hypertension guidelines (JNC 7) ascribe
a singular place to diuretics in first-line treatment of uncomplicated
hypertension following a one-sided interpretation
of the ALLHAT results. In contrast, in the guidelines
of the European Society of Hypertension published
in 2003, diuretics are placed alongside beta-blockers, angiotensin
converting enzyme inhibitors, sartans, and calcium
antagonists as the drugs of the first choice, but not preference.
Detailed analysis of ALLHAT, as well as ASCOT
study did not confirmed superiority of diuretics over other
classes of antihypertensive agents. ASCOT study has even
showed the superiority of new groups of antihypertensive
drugs over conventional therapy in the risk reduction of
serious cardiovascular complications of hypertension. The
aim of the study is to answer the question, if the actually
increasing position of diuretics in antihypertensive therapy
is scientifically and clinically justifiable, and if their less
expressive organoprotective actions and their numerous adverse
effects are strong enough arguments against the
therapeutic universality of this group of drugs.
Abstract
Diuretics are well-established antihypertensive agents. The
recent American hypertension guidelines (JNC 7) ascribe
a singular place to diuretics in first-line treatment of uncomplicated
hypertension following a one-sided interpretation
of the ALLHAT results. In contrast, in the guidelines
of the European Society of Hypertension published
in 2003, diuretics are placed alongside beta-blockers, angiotensin
converting enzyme inhibitors, sartans, and calcium
antagonists as the drugs of the first choice, but not preference.
Detailed analysis of ALLHAT, as well as ASCOT
study did not confirmed superiority of diuretics over other
classes of antihypertensive agents. ASCOT study has even
showed the superiority of new groups of antihypertensive
drugs over conventional therapy in the risk reduction of
serious cardiovascular complications of hypertension. The
aim of the study is to answer the question, if the actually
increasing position of diuretics in antihypertensive therapy
is scientifically and clinically justifiable, and if their less
expressive organoprotective actions and their numerous adverse
effects are strong enough arguments against the
therapeutic universality of this group of drugs.
Keywords
antihypertensive therapy; diuretics
Title
Diuretics in antihypertensive treatment - new facts, old concerns. Is it time for a right choice?
Journal
Arterial Hypertension
Issue
Vol 9, No 6 (2005)
Article type
Review paper
Pages
474-488
Published online
2005-12-13
Page views
538
Article views/downloads
6049
Bibliographic record
Nadciśnienie tętnicze 2005;9(6):474-488.
Keywords
antihypertensive therapy
diuretics
Authors
Urszula Brzezinska
Andrzej Tykarski
About this article