cardiovascular disorders
Medications for Hypertension
Diuretics for Hypertension
Main classes of diuretics used for hypertension (see table) are Loop diuretics Potassium-sparing diuretics Thiazide diuretics Diuretics modestly reduce plasma volume and reduce vascular resistance, possibly via shifts in sodium from intracellular to extracellular loci. Loop diureticsare used to treat hypertension only in patients who have an estimated GFR<30 mL/minute; these diuretics are given at least twice a day (except fortorsemidewhich can be given once a day). do not cause Hypokalemia , hyperuricemia, or hyperglycemia, they are not as effective as thiazide-type diuretics in controlling hypertension and thus are not used for initial treatment. Potassium-sparing diuretics or potassium supplements are not needed when an angiotensin-converting enzyme (ACE) inhibitor or . Although thiazide diuretics had previously been thought to be ineffective in patients with Stages of chronic kidney disease , , have a known heart disorder, have an abnormal ECG, have ectopy or Overview of Arrhythmias , or develop ectopy or arrhythmias while taking a diuretic. In most patients with Diabetes Mellitus (DM) , thiazide-type diuretics do not affect control of diabetes. Uncommonly, diuretics precipitate or worsen type 2 diabetes in patients with A hereditary predisposition probably explains the few cases of Gout due to diuretic-induced hyperuricemia. Diuretic-induced hyperuricemia without gout does not require treatment or discontinuation of the diuretic. Diuretics may slightly increase mortality in patients with a history of Heart Failure (HF) who do not have pulmonary congestion, particularly in those who are also taking an ACE inhibitor or 1.Agarwal R, Sinha AD, Tu W:Chlorthalidonefor hypertension in Advanced CKD. Reply.N Engl J Med386(14):1384, 2022. 2.Roush GC, Ernst ME, Kostis JB, Tandon S, Sica DA. Head-to-head comparisons ofhydrochlorothiazidewithindapamideandchlorthalidone: antihypertensive and metabolic effects.Hypertension65(5):1041-1046, 2015. doi:10.1161/HYPERTENSIONAHA.114.05021 3.Ott SM, LaCroix AZ, Ichikawa LE, Scholes D, Barlow WE. Effect of low-dose thiazide diuretics on plasma lipids: results from a double-blind, randomized clinical trial in older men and women.J Am Geriatr Soc51(3):340-347, 2003. doi:10.1046/j.1532-5415.2003.51107.x 