Should a diuretic always be the first choice in patients with essential hypertension? The case for no

Alberto Morganti

Research output: Contribution to journalArticlepeer-review

Abstract

A more extensive use of diuretics as first-line drug for the treatment of hypertensive patients has been recommended on the basis of the results of the recent Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial, yet diuretics have numerous drawbacks that may limit their undisputed ability to lower BP. These include the stimulation of the renin-angiotensin- aldosterone system with the attending negative cardiovascular effects that ensue from this activation and several metabolic alterations, namely those in glucose, lipid, and potassium metabolism. Numerous mechanistic as well as interventional trials indicate that these limitations of diuretics can adversely affect the clinical outcome of patients and their compliance to treatment and consequently the cost of therapy. In addition, there are a number of clinical conditions in which the diuretics are admittedly contraindicated as first-line drugs. Thus, the emphasis should be on obtaining optimal BP control rather on the drug used to achieve it.

Original languageEnglish
JournalJournal of the American Society of Nephrology
Volume16
Issue number3 SUPPL. 1
DOIs
Publication statusPublished - 2005

ASJC Scopus subject areas

  • Nephrology

Fingerprint Dive into the research topics of 'Should a diuretic always be the first choice in patients with essential hypertension? The case for no'. Together they form a unique fingerprint.

Cite this