Hemorrheologic effect of diuretics in the control of blood pressure in the hypertensive patient

Autor: Chávez-Negrete AJ; Dirección de Educación en Investigación en salud, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México. achavezn@gmail.com, Rojas-Uribe M, Gallardo-Montoya JM, Intaglietta M
Jazyk: Spanish; Castilian
Zdroj: Revista medica del Instituto Mexicano del Seguro Social [Rev Med Inst Mex Seguro Soc] 2017; Vol. 55 (Suppl 4), pp. S343-S349.
Abstrakt: Background: Diuretics are the first choice as an antihypertensive, because of its efficacy and cost, however its mechanism of action is not well understood. The aim of this work was to analyze the hemorrheological effect of the diuretics as vasodilators in patients with newly diagnosed arterial hypertension.
Methods: Patients with hypertension were given diet and exercise recommendations and 25 mg of chlorthalidone per day were prescribed; Hemoglobin/hematocrit, viscosity, and basal nitric oxide (ON) were determined at 15 and 45 days and compared with healthy subjects.
Results: We included 28 patients with average age of 48 years old; systolic blood pressure in the treated patients decreased from baseline at 15 days from 130 to 119 mm Hg and at 114 mmHg at 15 to 45 days; diastolic blood pressure decreased from baseline at 15 days from 103 to 97 mm Hg, and at 93 mmHg at 15 to 45 days. The hematocrit increased in both men and women with a statistical significance of the baseline period at 15 days, after that, it remained without significative changes. The viscosity increased similarly to the hematocrit, which conditioned the ON elevation.
Conclusions: The increase in hematocrit due to diuretic caused an increase in blood viscosity, which led to an increase in nitric oxide, resulting in lower blood pressure.
Databáze: MEDLINE