The place of diuretics in preventing cardiovascular events

Kaplan, Norman M.

doi:10.1038/sj.jhh.1001798

Cited by 10 publications

(4 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[18][19][20] The long-term studies have also shown that treating hypertension with diuretics reduces the incidence of coronary events by at least 14% to 16% and strokes by 40%. [18][19][20] The long-term studies have also shown that treating hypertension with diuretics reduces the incidence of coronary events by at least 14% to 16% and strokes by 40%.…”

Section: Cardiovascular Outcomes As a Results Of Treatment With Diureticsmentioning

confidence: 99%

“…22 The diuretic arm of the Medical Research Council (MRC) Trial in the elderly showed a reduction of 47% in coronary mortality. 19,20,24 The Hypertension Detection and Follow-Up Program (HDFP) and the Multiple Risk Factor Intervention Trial (MRFIT), extending over periods of 8.5 and 10.5 years, respectively, have shown a greater reduction in coronary events (by 20%) with low doses of diuretics. 19,20,24 The Hypertension Detection and Follow-Up Program (HDFP) and the Multiple Risk Factor Intervention Trial (MRFIT), extending over periods of 8.5 and 10.5 years, respectively, have shown a greater reduction in coronary events (by 20%) with low doses of diuretics.…”

Section: Cardiovascular Outcomes As a Results Of Treatment With Diureticsmentioning

confidence: 99%

See 1 more Smart Citation

Update of Diuretics in the Treatment of Hypertension

Padilla¹,

Armas-Hernández²,

Hernández³

et al. 2007

American Journal of Therapeutics

View full text Add to dashboard Cite

Diuretics, which are primarily used to modify the volume and the composition of body fluids, are widely used to treat hypertension. The diuretics include a) the thiazides and thiazide-like agents, which are the most common drugs used to treat high blood pressure (these drugs inhibit sodium reabsorption in the early distal convoluted tubule); b) loop diuretics, such as furosemide, block chloride and sodium reabsorption by inhibition of the Na/K/2Cl cotransport system in the thick ascending limb of the loop of Henle; and c) potassium-sparing (retaining) diuretics, including aldosterone receptor blockers (such as spironolactone and eplerenone) and epithelial sodium channel blockers (such as amiloride and triamterene, which interfere with the reabsorption of sodium and excretion of potassium and hydrogen that takes place in the late distal tubule, the connecting tubule, and the cortical collecting duct). Hydrochlorothiazide 12.5 mg once daily or equivalent low dosages of other similar agents reduce blood pressure in approximately one-half to two-thirds of patients who are responsive to this class of drugs; higher doses add little to the effect on blood pressure and also increase side effects. Some combinations of very small doses of thiazide diuretics - for example, 6.25 mg hydrochlorothiazide or 0.625 mg indapamide, with a low dose of an antihypertensive drug of a different class - have average antihypertensive efficacy when used once daily. Furosemide is used in patients with renal failure or severe heart failure and is best given by continuous intravenous infusion. The potassium-sparing diuretics are generally used in combination with thiazide diuretics to treat hypertension. Side effects occur at about the same frequency and severity with equipotent doses of all diuretics. The incidence of side effects is dose-dependent and also increases as a function of the duration of the renal excretory and antihypertensive actions. However, longer-acting diuretics provide better 24-hour control of blood pressure and increase compliance and adherence to the treatment regimen.

show abstract

Section: Cardiovascular Outcomes As a Results Of Treatment With Diureticsmentioning

confidence: 99%

Section: Cardiovascular Outcomes As a Results Of Treatment With Diureticsmentioning

confidence: 99%

Update of Diuretics in the Treatment of Hypertension

Padilla¹,

Armas-Hernández²,

Hernández³

et al. 2007

American Journal of Therapeutics

View full text Add to dashboard Cite

show abstract

“…These variables included age, race, ethnicity, education, BMI, recreational physical activity, season, diuretic medications (nonspecified indication), smoking status, and biomarker-estimated energy intake from doubly labeled water accounting for weight change during the 2-wk feeding period (Ein). Mean daily Na and K from the 2-wk 4-d repeating cycle consumed diet served as the referent of highly controlled usual intake ( 29 ). Diuretics taken by the NPAAS-FS participants included loop diuretics, thiazide and thiazide-like diuretics, and diuretic combinations and these were included in the main model due to their known effects on Na and K excretion ( 29 ).…”

Section: Methodsmentioning

confidence: 99%

“…Mean daily Na and K from the 2-wk 4-d repeating cycle consumed diet served as the referent of highly controlled usual intake ( 29 ). Diuretics taken by the NPAAS-FS participants included loop diuretics, thiazide and thiazide-like diuretics, and diuretic combinations and these were included in the main model due to their known effects on Na and K excretion ( 29 ). Variable selection for the biomarker equations was conducted using least absolute shrinkage and selection operator (LASSO) regression analysis ( 30 ) and the model was then refit using the selected variables.…”

Section: Methodsmentioning

confidence: 99%

Estimating 24-Hour Urinary Excretion of Sodium and Potassium Is More Reliable from 24-Hour Urine Than Spot Urine Sample in a Feeding Study of US Older Postmenopausal Women

Tinker

Huang

Johnson

et al. 2021

Current Developments in Nutrition

View full text Add to dashboard Cite

Background Assessing estimated sodium (Na) and potassium (K) intakes derived from 24-h urinary excretions versus a spot urine sample if comparable could reduce participant burden in epidemiologic and clinical studies. Objectives In a two-week controlled feeding study, Na and K excretion from a 24-h urine collection were compared with a first void spot urine sample, applying established algorithms and enhanced models to estimate 24-h excretion. Actual and estimated 24-h excretions were evaluated relative to mean daily Na and K intakes in the feeding study. Methods 153 older postmenopausal women ages 75.4 ± 3.5 years participated in a 2-week controlled feeding study with a 4-day repeating menu cycle based on their usual intake (ClinicalTrials.gov Identifier: NCT00000611). Of the 150 participants who provided both a first void spot urine sample and a 24-h urine collection on the penultimate study day, statistical methods included Pearson correlations for Na and K between intake, 24-h collections and the 24-h estimated excretions using four established algorithms; enhanced biomarker models by regressing ln-transformed intakes on ln-transformed 24-h excretions or ln-transformed 24-h estimated excretions plus participant characteristics; and sensitivity analyses for factors potentially influencing Na or K excretion, e.g., possible kidney disease estimated eGFR < 60 mL/min/1.73m). Results Pearson correlation coefficients between Na and K intakes and actual 24-h excretions were 0.57 and 0.38–0.44 for estimated 24-h excretions, depending on electrolyte and algorithm used. Enhanced biomarker model cross-validated R2 (CVR2s) for 24-h excretions were 38.5% (Na), 40.2% (K) and 42.0% (Na/K). After excluding participants with possible kidney disease, the CVR2s were 43.2% (Na), 40.2% (K) and 38.1% (Na/K). Conclusions 24-h urine excretion measurement performs better than estimated 24-h excretion from a spot urine as a biomarker for Na and K intake among a sample of primarily white postmenopausal women. Summary 24-h urine excretion measurement performs better than estimated 24-h excretion from a spot urine as a biomarker for Na and K intake among a sample of primarily white postmenopausal women.

show abstract