[Renaissance of diuretics in the treatment of hypertension].
Diuretics and beta-blockers are the only antihypertensives known for their significant reduction of cardiovascular morbidity and mortality, particularly in the elderly. The use of low-dose diuretics can improve the efficacy-safety ratio. Hypokalemia, hypomagnesemia as well as disturbances of carbohydrate and lipid metabolism are dose-dependent side effects of diuretics but only minimal during the low-dose therapy. A novel low-dose formulation of indapamide was developed as a sustained-release (SR) coated tablet (1.5 mg/day) and compared to the immediate release (IR) formulation of indapamide (2.5 mg/day). A > 50% reduction in the number of patients with serum potassium levels < 3.4 mmol/l among hypertensive patients treated with indapamide SR as compared to IR was observed. Indapamide SR has also been shown to be effective (more than 20 mg enalapril) in the reduction of left ventricular mass index (LVMI) in hypertensive patients treated for one year (LIVE study). Therefore, low-dose diuretics are, in accordance with international recommendations for the low-dose antihypertensive drugs, a first line therapy of hypertension.
Hörl
W H
WH
Klinische Abteilung für Nephrologie und Dialyse, Medizinische Universitätsklinik III, AKH Wien, Osterreich.
D000959:Antihypertensive Agents / Q000627:therapeutic use*; D003692:Delayed-Action Preparations; D004232:Diuretics / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007190:Indapamide / Q000627:therapeutic use; D013607:Tablets
D000959:Antihypertensive Agents; D003692:Delayed-Action Preparations; D004232:Diuretics; D013607:Tablets; D007190:Indapamide
Renaissance der Salidiuretika in der Therapie der Hypertonie.