Evidence for the efficacy of low-dose diuretic monotherapy

The American Journal of Medicine
J M Flack, W C Cushman

Abstract

Diuretic monotherapy has been recommended by the fifth report of the Joint National Committee on Detection, Evaluation and Treatment of High Blood Pressure (JNC-V) as a preferred initial treatment for hypertension. Thiazide diuretics are commonly used to treat hypertension because of their demonstrated efficacy, favorable safety profile, low acquisition cost, and their proven ability to reduce blood pressure-related morbidity and mortality. Once-daily low-dose hydrochlorothiazide (12.5 mg/ day) or chlorthalidone (15 mg/day) effectively reduces blood pressure in patients with stage 1 or stage 2 hypertension in comparison with placebo. Blood pressure reductions with low-dose hydrochlorothiazide and chlorthalidone are comparable to that achieved with higher doses (25 and 50 mg/day). Additional blood pressure reductions can be attained with concomitant use of once-daily low-dose hydrochlorothiazide or chlorthalidone with an angiotensin-converting enzyme (ACE) inhibitor, a beta blocker, or a calcium antagonist. Once-daily low-dose hydrochlorothiazide provides clinically meaningful blood pressure lowering while minimizing adverse effects, such as electrolyte disturbances, cholesterol elevations, and increases in serum uric acid levels.

References

May 31, 1978·European Journal of Clinical Pharmacology·B Beermann, M Groschinsky-grind
Nov 1, 1992·International Journal of Cardiology·C M SteinT Kusemamuriwo
Jun 1, 1987·Archives of Internal Medicine·R N WyndhamR P Russell
Oct 1, 1984·Drugs·W P Leary, A J Reyes
May 1, 1984·The American Journal of Cardiology·F A Finnerty
Jul 1, 1993·British Journal of Clinical Pharmacology·D L Davies, R Fraser

Citations

Sep 5, 2001·BMJ : British Medical Journal·F J He, G A MacGregor
Jun 21, 2001·The American Journal of Geriatric Cardiology·C E Okereke, F H Messerli
Aug 26, 2010·International Urology and Nephrology·Rebecca VigenRobert F Reilly
Jan 5, 2000·American Heart Journal·M R Weir, M Moser
May 20, 2014·Current Medical Research and Opinion·Steen NeldamJoel M Neutel
Mar 10, 2007·Hypertension Research : Official Journal of the Japanese Society of Hypertension·Kayo MuraiJ-Home Study Group
Feb 22, 2005·The Journal of Clinical Hypertension·Hardeep Singh, Michael L Johnson
Jan 22, 2014·Expert Opinion on Pharmacotherapy·Juan TamargoLuis M Ruilope
Oct 3, 2014·Circulation Journal : Official Journal of the Japanese Circulation Society·Takuma SawaHisayoshi Fujiwara
Jan 26, 2010·Expert Opinion on Drug Safety·Pantelis A SarafidisAnastasios N Lasaridis
Apr 2, 2005·Journal of the Renin-angiotensin-aldosterone System : JRAAS·Alun D Hughes
Dec 17, 2009·Cardiology in Review·Kimberly M Neff, James J Nawarskas
Jul 13, 2002·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Michael Böhm, Alisia Sachse

Related Concepts

Thalitone
Clinical Trials
Diuretic Effect
Polychemotherapy
Sectrazide
Hypertensive Disease
Best Practices
Potassium Depleting Diuretics

Related Feeds

Antihypertensive Agents: Mechanisms of Action

Antihypertensive drugs are used to treat hypertension (high blood pressure) which aims to prevent the complications of high blood pressure, such as stroke and myocardial infarction. Discover the latest research on antihypertensive drugs and their mechanism of action here.