Diuretics in the Therapy of Hypertension: Current Status

O’Donovan, Richard A.; Muhammedi, Muhammed; Puschett, Jules B.

doi:10.1097/00000441-199211000-00009

Cited by 15 publications

(7 citation statements)

References 83 publications

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“…The deleterious effect of diuretics reported with the higher doses of thiazides which cause hypokalemia, glucose intolerance, and hyperuricemia but reduction in dose causes little additional reduction in blood pressure. Diuretics enhance the efficacy of other classes pointed out by guideline and will most often be a component of combination therapy [24–26]. The diuretics should not be the initial therapy in hypertension.…”

Section: Current Status Of Diuretics In Hypertensionmentioning

confidence: 99%

The target‐specific transporter and current status of diuretics as antihypertensive

Ali¹,

Sharma

Garg

et al. 2011

Fundamemntal Clinical Pharma

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The currently available diuretics increase the urinary excretion of sodium chloride by selective inhibition of specific sodium transporters in the loop of Henle and distal nephron. In recent years, the molecular cloning of the diuretic-sensitive sodium transporters at distal convoluted tubule has improved our understanding of the cellular mechanisms of action of each class of diuretics. Diuretics are tools of considerable therapeutic importance. First, they effectively reduce blood pressure. Loop and thiazide diuretics are secreted from the proximal tubule via the organic anion transporter-1 and exert their diuretic action by binding to the Na(+)-K(+)-2Cl(-) co-transporter type 2 in the thick ascending limb and the Na(+)-Cl(-) co-transporter in the distal convoluted tubule, respectively. Recent studies in animal models suggest that abundance of these ion transporters is affected by long-term diuretic administration. The WHO/ISH guidelines point out that diuretics enhance the efficacy of antihypertensive drugs and will most often be a component of combination therapy.

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Section: Current Status Of Diuretics In Hypertensionmentioning

confidence: 99%

The target‐specific transporter and current status of diuretics as antihypertensive

Ali¹,

Sharma

Garg

et al. 2011

Fundamemntal Clinical Pharma

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“…A diuretic is usually the drug of choice for the initial treatment of hypertension; potassium-sparing agents are used if hypokalemia is noted during the first 6 months of treatment. They are also commonly used as adjuncts to other antihypertensive drugs 52 and are especially useful in patients with hypercalciuria, calcium stones, and osteoporosis, since they decrease calcium excretion. The first group of diuretics includes the thiazides, of which the prototype is hydrochlorothiazide, and chlorthalidone is the diuretic studied in the ALLHAT trial.…”

Section: Diureticsmentioning

confidence: 99%

Hypertension and the Vascular Patient

Samson

2004

Vasc Endovascular Surg

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Hypertension is intricately entwined in vascular pathology and morbidity and uncontrolled blood pressure is a leading cause of cardiovascular mortality. Unfortunately, many patients will present to the vascular surgeon with uncontrolled blood pressure elevation and yet, although vascular surgeons have been involved in treating the renovascular etiology, they seldom become actively involved in the medical management of hypertension. However, positive reinforcement by the vascular surgeon about the benefits of blood pressure control may significantly impact the patient's willingness to comply with medications. Some of these medications may also have secondary benefits such as reducing the incidence of diabetes. Accordingly modern vascular surgeons, who want to do more for their patients, need to have a basic understanding of hypertension and its treatment. This manuscript provides an overview of the modern definitions and treatment methods for primary hypertension that should provide the vascular surgeon with sufficient information to play an active role in the management of this co-morbid condition.

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“…Although there are few data available on the incidence of this complication following diuretic administration, it appears to be rather smaIl, and seems to require very long-term, marked levels of depletion [89][90][91]. This is especially true contemporaneously, given the emphasis placed in recent years on potassium replacement, and because of the more recent emphasis on the use of lower doses of diuretics for the treatment of hypertension than were originally employed [92]. Currently, it is generally seen only in patients who abuse diuretics and laxatives [90,93].…”

Section: Hypokalemic Nephropathymentioning

confidence: 99%