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Body Composition Changes in Hypertensive Subjects on Long-term Oral Diuretic Therapy

Hypertensive patients were treated with either chlorthalidone or frusemide for periods of two to four months. Reduction in blood pressure was seen with chlorthalidone but not with frusemide. This hypotensive effect appeared to be independent of the natriuretic effect. A significant reduction in total exchangeable potassium (KE) was seen with both agents, but no patient showed adverse symptoms or signs. There was no alteration in maximal urinary concentration or acidification, or in intravenous glucose tolerance or plasma insulin. It is concluded that potassium depletion of this degree does not require replacement therapy on a routine basis in hypertensive patients.