Journal article
Diuretics: a review and update
Journal of cardiovascular pharmacology and therapeutics, Vol.19(1), pp.5-13
01/2014
DOI: 10.1177/1074248413497257
PMID: 24243991
Abstract
Diuretics have been recommended as first-line treatment of hypertension and are also valuable in the management of hypervolemia and electrolyte disorders. This review summarizes the key features of the most commonly used diuretics. We then provide an update of clinical trials for diuretics during the past 5 years. Compared to other classes of medications, thiazide diuretics are at least as effective in reducing cardiovascular events (CVEs) in patients with hypertension and are more effective than β-blockers and angiotensin-converting enzyme inhibitors in reducing stroke. Observational cohort data and a network analysis have shown that CVEs are lowered by one-fifth from chlorthalidone when compared to the commonly used thiazide, hydrochlorothiazide. Relative to placebo, chlorthalidone increases life expectancy. In those aged 80 years and older, the diuretic, indapamide, lowers CVEs relative to placebo. The aldosterone antagonist, eplerenone, lowers total mortality in early congestive heart failure. The benefit of eplerenone following acute myocardial infarction (MI) is limited to administration within 3 to 6 days post-MI. Aldosterone antagonists have been shown to lower the incidence of sudden cardiac death and to reduce proteinuria. In the setting of heart failure, long acting loop diuretics azosemide and torasemide are more effective in improving heart failure outcomes than the far more commonly used short acting furosemide. Evening dosing of diuretics appears to lower CVEs relative to morning dosing. In conclusion, diuretics are a diverse class of drugs that remain extremely important in the management of hypertension and hypervolemic states.
Details
- Title: Subtitle
- Diuretics: a review and update
- Creators
- George C Roush - St. Vincent's Medical CenterRamdeep Kaur - St. Vincent's Medical CenterMichael E Ernst - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Journal of cardiovascular pharmacology and therapeutics, Vol.19(1), pp.5-13
- DOI
- 10.1177/1074248413497257
- PMID
- 24243991
- ISSN
- 1074-2484
- eISSN
- 1940-4034
- Language
- English
- Date published
- 01/2014
- Academic Unit
- Family and Community Medicine; Pharmacy Practice and Science
- Record Identifier
- 9984297443802771
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