open access

Vol 9, No 6 (2005)
REVIEV
Published online: 2005-12-13
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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.

open access

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.
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Keywords

antihypertensive therapy; diuretics

About this article
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)

Pages

474-488

Published online

2005-12-13

Bibliographic record

Nadciśnienie tętnicze 2005;9(6):474-488.

Keywords

antihypertensive therapy
diuretics

Authors

Urszula Brzezinska
Andrzej Tykarski

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