open access

Vol 7, No 3 (2003)
Artykuły redakcyjne
Published online: 2003-07-21
Get Citation

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.

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.
Get Citation

Keywords

antihypertensive treatment; thiazide diuretics

About this article
Title

Diuretics in Antihypertensive Therapy - Does History Described a Circle?

Journal

Arterial Hypertension

Issue

Vol 7, No 3 (2003)

Pages

129-139

Published online

2003-07-21

Bibliographic record

Nadciśnienie tętnicze 2003;7(3):129-139.

Keywords

antihypertensive treatment
thiazide diuretics

Authors

Andrzej Tykarski

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail: viamedica@viamedica.pl