Why are diuretics used to treat hypertension?
Diuretics help rid your body of sodium and water. Most work by making your kidneys release more sodium into the urine. The sodium then takes water with it from your blood decreasing the amount of fluid flowing through your blood vessels hence lowering blood pressure.
Do diuretics lower systolic blood pressure?
The diuretic was better at lowering systolic blood pressure -- the top number -- than the newer drugs, but Norvasc was better at lowering diastolic blood pressure -- the bottom number.Dec 17, 2002
What is the best treatment for systolic hypertension?
Thiazide diuretics and dihydropyridine calcium-channel blockers are the primary compounds used in randomized clinical trials. These drugs can be considered as first-line agents for the management of isolated systolic hypertension.Jun 25, 2020
Why are diuretics first-line for hypertension?
First-line treatment of hypertension with thiazide diuretics has been shown to significantly reduce serious cardiovascular morbidity (stroke and myocardial infarction [MI]) and mortality in randomised controlled trials, with benefits at least as great as first-line treatment with other classes of antihypertensive drug ...Apr 26, 2005
Can a diuretic be used to treat hypertension?
Diuretics are a class of medications that remove water and electrolytes from the body by increasing urination. They're often used to treat hypertension, also known as high blood pressure.
Are diuretics safe for high blood pressure?
Medications such as diuretics can be key for people with high blood pressure. By causing you to urinate more often, the drugs can help remove excess water and salt from your body. In turn, diuretics can help lower blood pressure and reduce the risk of complications such as heart attacks or strokes.Feb 18, 2020
When is systolic hypertension treated?
The recommended goal for systolic pressure for adults younger than age 65 with a 10% or higher risk of developing cardiovascular disease is less than 130 mm Hg. For healthy adults who are age 65 or older, the recommended treatment goal for systolic pressure is also less than 130 mm Hg.Apr 29, 2020
What are diuretics?
Diuretics, sometimes called water pills, help rid your body of salt (sodium) and water. Most of these medicines help your kidneys release more sodium into your urine. The sodium helps remove water from your blood, decreasing the amount of fluid flowing through your veins and arteries. This reduces blood pressure.
What is a thiazide diuretic drug?
Thiazide diuretics are a type of diuretic (a drug that increases urine flow). They act directly on the kidneys and promote diuresis (urine flow) by inhibiting the sodium/chloride cotransporter located in the distal convoluted tubule of a nephron (the functional unit of a kidney).
What is the first line treatment for diuretic?
The strongest body of evidence indicates that for most patients with hypertension, thiazide diuretics are the best proven first-line treatment in reducing morbidity and mortality.Jun 1, 2010
What is the first line treatment for hypertension?
There are three main classes of medication that are usually in the first line of treatment for hypertension: 1. Calcium Channel Blockers (CCB) 2. Angiotensin Converting Enzyme inhibitors (ACE inhibitors or ACE-I) and Angiotensin Receptor Blockers (ARBs) 3. Diuretics.
What is the first line of treatment for high blood pressure?
Initial first-line therapy for stage 1 hypertension includes thiazide diuretics, CCBs, and ACE inhibitors or ARBs. Two first-line drugs of different classes are recommended with stage 2 hypertension and average BP of 20/10 mm Hg above the BP target.May 7, 2018
What is the most commonly prescribed diuretic for hypertension?
Diuretics have long been used for the treatment of hypertension. Thiazide diuretics are the most commonly prescribed diuretics for hypertension, but other classes of diuretics may be useful in alternative circumstances.
What are the side effects of thiazides?
Common side effects of thiazides are mostly dose-related and involve electrolyte and metabolic abnormalities.
Can diuretics be used for hypertension?
Although diuretics are no longer considered the preferred agent for treatment of hypertension in adults and children, they remain acceptable first-line options. Diuretics effectively decrease blood pressure in hypertensive patients, and in adults with hypertension reduce the risk of adverse cardiovascular outcomes.
What foods can help with hypertension?
dark leafy greens, such as kale and spinach. squash. mushrooms. potatoes. yogurt. fish. Potassium-sparing diuretics don’t pose as much as a threat to your potassium levels. However, they aren’t as effective in treating hypertension as the other types of diuretic medications, so they are often prescribed along with other drugs.
What are some examples of thiazides?
Examples of thiazides include metolazone (Zaroxolyn), indapamide (Lozol), and hydrochlorothiazide (Microzide).
What are the side effects of a syringe?
Other side effects may include: 1 headaches 2 dizziness or lightheadedness 3 difficulty sleeping 4 muscle weakness or cramping 5 increased thirst 6 irregular menstruation 7 impotence, or#N#difficulty achieving and maintaining an erection 8 gout,#N#or conditions that cause swelling and pain in the joints of the foot
Is it safe to take diuretics?
Risks and Side Effects. Diuretics are generally safe for most people when taken as prescribed. The most common side effect of diuretics is increased urination. Your potassium, glucose, and cholesterol levels may fluctuate depending on the type of diuretic you’re taking.
Can gout cause pain in the foot?
gout, or conditions that cause swelling and pain in the joints of the foot. Side effects are likely to decrease over time. Make sure to notify your doctor if you experience uncomfortable or prolonged side effects while taking a diuretic. Your doctor may adjust your dosage or switch you to a different type of diuretic medication.
Does thiazide lower blood pressure?
The reduction in blood volume slows the rate at which blood flows through your blood vessels , helping to decrease your blood pressure. Thiazide and loop diuretics may also cause you to lose potassium in addition to water and sodium.
Can thiazide be used for hypertension?
However, your doctor will tailor your drug regimen to your specific health concerns . Your specific medication may contain more than one type of diuretic agent in a single pill or dose.
How do diuretics help with blood pressure?
Diuretics help rid your body of sodium and water. Most work by making your kidneys release more sodium into the urine. The sodium then takes water with it from your blood decreasing the amount of fluid flowing through your blood vessels hence lowering blood pressure.
Why are diuretics prescribed?
Diuretics are used effectively in the management of hypertension, and are typically prescribed because of their efficacy, low cost, and low side effects profile. Diuretics are known for their ability to increase the formation and excretion of urine.
How does thiazide diuretics work?
Thiazide diuretics act on the distal tubule of the nephron by inhibiting sodium reabsorption. With this inhibition, more sodium stays within the nephron creating an osmotic force that allows for water retention in the nephron, and ultimately water excretion.
How long does a loop diuretic last?
On the other hand, loop diuretics are known to be less effective than thiazides, and have a short duration of action at approximately 6 hours. Loop diuretics are indicated for patients with coexistent renal or heart failure, in circumstances when thiazide diuretics are rarely effective.
Does sodium lower blood pressure?
The sodium then takes water with it from your blood decreasing the amount of fluid flowing through your blood vessels hence lowering blood pressure . Diuretics are used effectively in the management of hypertension, and are typically prescribed because of their efficacy, low cost, and low side effects profile.
What is the first line of treatment for black patients?
Latin American Society of Hypertension and ACC/AHA guidelines recommend a thiazide-likediuretic or a CCB as the first-line treatment for black patients in monotherapy or as part of a combination therapy [5–7]. Several studies support the idea that diuretics are particularly efficacious in this patient population.
Is diuretic a first line treatment?
Diuretics are listed in hypertension guidelines as one of three equally weighted first-line treatment options . In order to differentiate between antihypertensives, a lot of discussion has been directed at side effect profiles and as a result, has created a perhaps disproportionate fear of the metabolic effects that can be associated with diuretics. Data, however, show that the risk of a clinically meaningful change in laboratory parameters is very low, whereas the benefits of volume control and natriuresis are high and the reductions in morbidity and mortality are clinically significant. Moreover, as clinically significant differences in safety and efficacy profiles exist among diuretics, several international guidelines have started making a distinction between thiazides ( hydrochlorothiazide) and thiazide-like ( chlorthalidone, indapamide) diuretics; and some of them now recommend longer acting thiazide-like diuretics. In time, pending more data, chlorthalidone and indapamide may need to be subdivided further into separate classifications.
What is the purpose of diuretics?
Diuretics, also known as water pills, are medications that promote urination and reduce fluid retention in the body. Diuretics inhibit the kidney from reabsorbing sodium, which normally happens during blood filtration. The release of sodium also leads to the elimination of excess fluid by way of increased urine output.
How do diuretics help the kidneys?
Diuretics help the kidneys flush out the excess fluid and maintain normal blood volume. The elimination of excess fluid reduces pressure in the veins and the overload of venous blood into the heart. As a result, the heart requires less effort to pump out blood, and the blood pressure in the arteries drops. The fluid accumulated in the lungs and ...
What is the condition where the heart is unable to pump blood to meet the body's oxygen and nutrient
Congestive heart failure is a condition in which the heart is unable to efficiently pump blood to meet the body’s oxygen and nutrient needs. This impairs normal blood circulation and leads to excess fluid in the blood. The excess fluid leaks out of the blood vessels and accumulates in the lungs and other tissues.
What are the symptoms of congestive heart failure?
The primary symptoms of congestive heart failure include: Shortness of breath (dyspnea) from fluid collection around the lungs, Swelling of lower limbs (peripheral edema) Fatigue and reduced capacity for exercise.
What is thiazide used for?
Thiazide diuretics are commonly used to treat high blood pressure ( hypertension ), but also to manage heart failure. Thiazide diuretics inhibit a different protein than the loop diuretics do, which also helps in mineral reabsorption. Thiazide diuretics include:
What is the purpose of Vasopressin antagonists?
Vasopressin antagonists: Vasopressin antagonists are a new class of drugs being studied for use in heart failure. This class of drugs works by blocking vasopressin, which is an antidiuretic hormone produced by the pituitary gland. Ultrafiltration: Ultrafiltration is the removal of excess fluid in the blood with the use of a machine.
What are the functions of the kidney?
The nephrons produce certain proteins which help filter the wastes from the blood, and reabsorb minerals such as sodium, potassium and chloride for circulation in the blood.
What percentage of people with hypertension are white?
The incidence of hypertension increases with age. Approximately 65% of elderly persons have been diagnosed as hypertensive. At ages 65–74 years, hypertension is present in 53% of non-Hispanic whites, 72% of non-Hispanic African Americans and 55% of Mexican Americans. 1 In geriatric patients aged 80 years and above, about 60% of men and 74% of women are hypertensives. 2 Hypertension represents one of the major risk factors for cardiovascular morbidity and mortality in the elderly. The risk related to hypertension has been demonstrated for stroke, left ventricular hypertrophy, congestive heart failure (CHF), coronary and peripheral artery diseases, end-stage renal disease, cognitive impairment and dementia. Both systolic blood pressure (SBP) and diastolic blood pressure (DBP) are established risk factors, but with advancing age SBP becomes a better predictor than DBP. However, in this population of older subjects who are over 65 years, the lowest rates of blood pressure (BP) control is observed. All the recent recommendations of experts (JNC VII, 3 ESH-ESC, 4 WHO-ISH 5) indicate that thiazide-type diuretics are to be favoured in elderly patients. This recommendation is based on evidence from long-term, controlled clinical trials, showing that these agents have excellent efficacy in lowering BP and reduce morbidity and mortality from cerebrovascular and cardiovascular disease. In this context, thiazide-type diuretics represent one of the principal antihypertensive agents to use for the treatment of hypertension in the elderly, because of their efficacy and good tolerance whether in monotherapy or in association with other drug families.
What age group is thiazide used in?
Since 2000, several studies have compared the effects of thiazide-type diuretics with other ‘new classes’ of antihypertensive agents, particularly calcium channel blockers or ACE inhibitors, in the populations of elderly hypertensives (mean age 60 to 76 years).
Is high blood pressure a risk factor for cardiovascular disease?
High blood pressure (BP) is a major risk factor for cardiovascular and cerebrovascular diseases in elderly subjects. Antihypertensive drugs have shown clinical benefit both in primary and secondary prevention of cardiovascular events. If BP lowering represents the major determinant of the effects conferred by the antihypertensive treatment for prevention, recent studies have suggested some differences between classes of antihypertensive drugs according to age. Based on the available clinical data, the recent medical guidelines have recommended thiazide-type diuretics as the preferred drug for the treatment of elderly hypertensive patients, followed by long-acting calcium antagonists. Indeed, diuretics constitute one of the most valuable classes of antihypertensive drugs, and in the elderly, diuretic-based treatment studies have been clearly shown to prevent major cardiovascular events, including stroke, heart failure and coronary heart disease.
Can diuretics be used as a first line therapy?
The principal randomised placebo-controlled trials of antihypertensive treatment in elderly hypertensive patients have used a diuretic or a beta blocker as first-line therapy. In the elderly, diuretics have clearly demonstrated BP-lowering efficacy and a proven ability to prevent strokes, myocardial infarction and CHF, when they are used as first-line therapy or added as a second-line therapy. The effects of thiazide-type diuretics in elderly hypertensive patients on cardiovascular prevention are summarised in Table 1 (used as first-line therapy) and in Table 2 (added as a second-line therapy). In all these studies, diuretics were superior to placebo and similar or superior to the other antihypertensive drugs for the prevention of cardiovascular events.
Is thiazide a better diuretic than ACE?
Some studies demonstrate no difference between both drugs, others suggest a better prevention with diuretics whereas others still suggest better pre vention with ACE inhibitors .
Can elderly people take diuretics?
Most recent studies on elderly hypertensives have included diuretics as second-line therapy when the first therapy was not based on diuretics. All these trials demonstrated the benefit of two-drug combination therapies in terms of cardiovascular mortality/morbidity prevention. The following two-drug combinations, including thiazide-type diuretics, have been found to be effective and well tolerated in elderly hypertensive patients ( Table 2 ):
Is antihypertensive medicine evidence based?
With regard to the question about the benefit of antihypertensive treatment in the ‘very elderly’ subjects over 80 years, no answer of evidence-based medicine exists in the literature. Indeed, no randomised controlled study has specifically evaluated the effect of antihypertensive drugs in a population aged over 80 years. A meta-analysis 32 of data including 1670 participants aged 80 years and over in randomised controlled trials of antihypertensive drugs has been published. The results suggested that active treatment prevented 34% (95% CI=8–52%) of strokes. Rates of major cardiovascular events and heart failure were also significantly decreased by 22 and 39%, respectively. However, no treatment benefit for cardiovascular mortality was observed. Moreover, a nonsignificant 6% (−5 to 18%) excess of deaths from all causes has been reported, as described in some epidemiological studies. Most of the studies from this analysis included trials using thiazide-type diuretics (EWPHE, SHEP, STOP).
