| Should a diuretic always be the first choice in patients with essential hypertension? The case for no. | |
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MedLine Citation:
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PMID: 15938039 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Alberto Morganti |
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Publication Detail:
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Type: Comparative Study; Journal Article; Review |
Journal Detail:
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Title: Journal of the American Society of Nephrology : JASN Volume: 16 Suppl 1 ISSN: 1046-6673 ISO Abbreviation: J. Am. Soc. Nephrol. Publication Date: 2005 Mar |
Date Detail:
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Created Date: 2005-06-06 Completed Date: 2005-07-01 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9013836 Medline TA: J Am Soc Nephrol Country: United States |
Other Details:
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Languages: eng Pagination: S70-3 Citation Subset: IM |
Affiliation:
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Cattedra di Medicina Interna and Centro Ipertensione Arteriosa, Ospedale S. Paolo, University of Milan, Milan, Italy. alberto.morganti@unimi.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Cardiovascular Diseases
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prevention & control* Diuretics / adverse effects, therapeutic use* Dose-Response Relationship, Drug Drug Administration Schedule Drug Utilization Female Follow-Up Studies Humans Hypertension / diagnosis, drug therapy* Male Randomized Controlled Trials as Topic Renin-Angiotensin System / drug effects*, physiology Risk Assessment Severity of Illness Index Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Diuretics |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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