Document Detail


Comparison of calcium-entry blockers and diuretics in the treatment of hypertensive patients.
MedLine Citation:
PMID:  3552313     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This review compares the calcium antagonists with diuretics in the management of mild-to-moderate essential hypertension. The antihypertensive efficacy of calcium antagonists appears comparable to that of oral diuretics such as hydrochlorothiazide when used as monotherapy. Peripheral vascular dilation appears to be the principal mechanism of the long-term blood pressure-lowering effects of both calcium antagonists and diuretics. Peripheral vasoconstrictor responses to cardioreflex-mediated sympathetic nervous system activation is attenuated by calcium antagonists but not by diuretics. Long-term calcium antagonist therapy is generally not associated with reflex activation of the sympathetic nervous system or of the renin-angiotensin-aldosterone axis, whereas diuretic therapy results in considerable activation of the renin-angiotensin-aldosterone system. Calcium antagonists appear to have a greater beneficial effect than diuretics with respect to maintenance of renal blood flow and glomerular filtration rate. Calcium antagonists, because of their effects on coronary blood flow and heart rate-blood pressure product, offer advantages over diuretics in the treatment of hypertensive patients with concomitant ischemic heart disease. Metabolic abnormalities associated with diuretic antihypertensive therapy, such as hypokalemia, hypercalcemia, hyperuricemia, lipid changes, and hyperglycemia, are generally not observed with calcium antagonists. Many of these deleterious metabolic changes observed with diuretic therapy may be minimized by the use of smaller doses of these agents than have generally been employed in the past. Diuretics are less expensive and require less frequent dosing than calcium antagonists. Thus, they continue to be preferable first-line antihypertensive agents in many patients with mild-to-moderate hypertension.
Authors:
J R Sowers; P K Mohanty
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Review    
Journal Detail:
Title:  Circulation     Volume:  75     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1987 Jun 
Date Detail:
Created Date:  1987-06-24     Completed Date:  1987-06-24     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  V170-3     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Calcium Channel Blockers / adverse effects,  therapeutic use*
Cardiovascular System / drug effects
Clinical Trials as Topic
Diuretics / adverse effects,  therapeutic use*
Humans
Hypertension / drug therapy*
Kidney / drug effects
Chemical
Reg. No./Substance:
0/Calcium Channel Blockers; 0/Diuretics

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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