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Vol 7, No 3 (2003)
Editorial
Published online: 2003-07-21
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Diuretics in Antihypertensive Therapy - Does History Described a Circle?
Andrzej Tykarski
Nadciśnienie tętnicze 2003;7(3):129-139.
open access
Vol 7, No 3 (2003)
Artykuły redakcyjne
Published online: 2003-07-21
Abstract
The JNC 7 guidelines recommend thiazide diuretics as first line treatment in uncomplicated hypertension. The
rationale for this recommendation comes from the results of the ALLHAT trial, where thiazide diuretic was equally
effective as calcium channel blocker and angiotensin converting enzyme inhibitor in the prevention of serious
cardiovascular events and even more effective than the other drugs in the reduction of some cardiovascular
complications (stroke, heart failure).
This review presents arguments for and against this opinion. Mechanisms of antihypertensive action of thiazide diuretics, their metabolic and electrolyte adverse reactions, end-organ protection and the results of other clinical trials are discussed and compared with placebo and other, newer antihypertensives. The authors also review the indications for thiazide diuretics in hypotensive treatment. It seems that in the light of the recent clinical trials thiazide diuretics should be used more widely but there is little evidence that they should be regarded as first line treatment in every case of hypertension.
This review presents arguments for and against this opinion. Mechanisms of antihypertensive action of thiazide diuretics, their metabolic and electrolyte adverse reactions, end-organ protection and the results of other clinical trials are discussed and compared with placebo and other, newer antihypertensives. The authors also review the indications for thiazide diuretics in hypotensive treatment. It seems that in the light of the recent clinical trials thiazide diuretics should be used more widely but there is little evidence that they should be regarded as first line treatment in every case of hypertension.
Abstract
The JNC 7 guidelines recommend thiazide diuretics as first line treatment in uncomplicated hypertension. The
rationale for this recommendation comes from the results of the ALLHAT trial, where thiazide diuretic was equally
effective as calcium channel blocker and angiotensin converting enzyme inhibitor in the prevention of serious
cardiovascular events and even more effective than the other drugs in the reduction of some cardiovascular
complications (stroke, heart failure).
This review presents arguments for and against this opinion. Mechanisms of antihypertensive action of thiazide diuretics, their metabolic and electrolyte adverse reactions, end-organ protection and the results of other clinical trials are discussed and compared with placebo and other, newer antihypertensives. The authors also review the indications for thiazide diuretics in hypotensive treatment. It seems that in the light of the recent clinical trials thiazide diuretics should be used more widely but there is little evidence that they should be regarded as first line treatment in every case of hypertension.
This review presents arguments for and against this opinion. Mechanisms of antihypertensive action of thiazide diuretics, their metabolic and electrolyte adverse reactions, end-organ protection and the results of other clinical trials are discussed and compared with placebo and other, newer antihypertensives. The authors also review the indications for thiazide diuretics in hypotensive treatment. It seems that in the light of the recent clinical trials thiazide diuretics should be used more widely but there is little evidence that they should be regarded as first line treatment in every case of hypertension.
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Keywords
antihypertensive treatment; thiazide diuretics
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Diuretics in Antihypertensive Therapy - Does History Described a Circle?
Journal
Issue
Article type
Editorial
Pages
129-139
Published online
2003-07-21
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Bibliographic record
Nadciśnienie tętnicze 2003;7(3):129-139.
Keywords
antihypertensive treatment
thiazide diuretics
Authors
Andrzej Tykarski