[Diuretics in arterial hypertension: a firm commitment for the 90's?].
A clinical pharmacology review of thiazide diuretics is presented in this paper, highlighting the mechanism of action, dosage considerations in order to optimize both the monotherapy or combination treatment, most relevant metabolic effects and adverse reactions, and clinically significant drug interactions. Reference is made to several attemps of limiting or reducing the popularity of their use which took place in mid eighties. At present, there are no data to substantiate that diuretics are implicated for the lack of a consistent reduction in coronary heart disease events. As a consequence of the renewed interest in the development of drugs with diuretic antihypertensive action, the physiologic changes associated with the use of indapamide have been briefly characterized. This agent is also perceived as having more favourable neutral metabolic profile at subnatriuretic dosage. After careful consideration of relevant scientific evidence and a critical appraisal of individualized approach to antihypertensive therapy, diuretics should be given serious consideration as valid alternative to modern antihypertensive agents in years to come.
Ranchhod
R
R
Hospital de Santa Maria/Faculdade de Medicina de Lisboa, Portugal.
D004232:Diuretics / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use*; D004347:Drug Interactions; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*
D004232:Diuretics
Diuréticos na hipertensão arterial: um compromisso firme para a década de 90?