Redefining diuretics use in hypertension
Autor: | George L. Bakris, Bryan Williams, Michel Burnier |
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Rok vydání: | 2019 |
Předmět: |
medicine.medical_specialty
hypertension Side effect Physiology thiazide-like 030204 cardiovascular system & hematology Volume control Natriuresis Thiazide-like Diuretic Thiazides 03 medical and health sciences 0302 clinical medicine Hydrochlorothiazide Internal Medicine medicine Humans 030212 general & internal medicine Diuretics Intensive care medicine indapamide business.industry Indapamide hydrochlorothiazide Metabolic effects Practice Guidelines as Topic Reviews and Meta-Analyses chlorthalidone Chlorthalidone thiazide Cardiology and Cardiovascular Medicine business medicine.drug |
Zdroj: | Journal of Hypertension |
ISSN: | 0263-6352 |
DOI: | 10.1097/hjh.0000000000002088 |
Popis: | Diuretics are listed in hypertension guidelines as one of three equally weighted first-line treatment options. In order to differentiate between antihypertensives, a lot of discussion has been directed at side effect profiles and as a result, has created a perhaps disproportionate fear of the metabolic effects that can be associated with diuretics. Data, however, show that the risk of a clinically meaningful change in laboratory parameters is very low, whereas the benefits of volume control and natriuresis are high and the reductions in morbidity and mortality are clinically significant. Moreover, as clinically significant differences in safety and efficacy profiles exist among diuretics, several international guidelines have started making a distinction between thiazides (hydrochlorothiazide) and thiazide-like (chlorthalidone, indapamide) diuretics; and some of them now recommend longer acting thiazide-like diuretics. In time, pending more data, chlorthalidone and indapamide may need to be subdivided further into separate classifications. |
Databáze: | OpenAIRE |
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