Diuretics: drugs of choice for the initial management of patients with hypertension.

Abstract

The optimal first-line treatment of hypertension has been a contentious issue. Despite the probable advantage of diuretics, which was demonstrated in early clinical trials, concern about their metabolic effects meant that therapy was often commenced with drugs of other types. The results of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT), which compared agents of three groups of new antihypertensive drugs with a diuretic, demonstrated the equivalence between these drugs and chlorthalidone (Tenoretic AstraZeneca) in the prevention of incident fatal coronary heart disease and nonfatal myocardial infarction. The diuretic was superior to other drugs in preventing some major secondary end-points, such as cerebrovascular disease and heart failure. These findings, together with other very practical reasons, such as easy administration, few side effects and low cost, demonstrate that diuretics are the first option for drug management of hypertension.

• Authors: Flávio D Fuchs
• Journal: Expert review of cardiovascular therapy (Expert Rev Cardiovasc Ther) Vol. 1 Issue 1 Pg. 35-41 (May 2003) ISSN: 1477-9072 [Print] England
• PMID: 15030295 (Publication Type: Journal Article, Review)

Chemical References

• Angiotensin-Converting Enzyme Inhibitors
• Antihypertensive Agents
• Diuretics
• Hypolipidemic Agents
• Lisinopril
• Chlorthalidone

Topics

• Angiotensin-Converting Enzyme Inhibitors (administration & dosage)
• Antihypertensive Agents (administration & dosage)
• Chlorthalidone (administration & dosage)
• Diuretics (administration & dosage)
• Drug Therapy, Combination
• Humans
• Hypertension (drug therapy)
• Hypolipidemic Agents (administration & dosage)
• Lisinopril (administration & dosage)
• Randomized Controlled Trials as Topic