PMID: 6829426Feb 24, 1983Paper

New approaches to the therapy of mild hypertension

The American Journal of Cardiology
N M Kaplan

Abstract

Concern about the initial use of diuretic agents under the stepped-care approach to the treatment of hypertension has been voiced before. Recently, however, the level of concern has risen as the results of various trials have questioned the safety of these agents in mild hypertension. Diuretic-induced hypokalemia has been reported in 10 to 30% of patients on long-term treatment. Recent studies show that hypokalemia may lead to previously unsuspected and potentially fatal arrhythmias, particularly after infarction. Increases in plasma cholesterol of 10 to 20 mg/dl may occur with diuretic therapy. Diuretics are also known to decrease glucose tolerance. Beta-adrenergic blocking drugs, although useful in many situations, are contraindicated in about 25% of the hypertensive population. These agents may also pose a long-term atherogenic risk because of their adverse effect on lipid and glucose metabolism. If all these effects have the potential to increase the risk of coronary heart disease over the long term, then first-line administration of diuretic therapy and, to a lesser extent, beta-blocking therapy, to the 25 to 30 million Americans with diastolic pressure in the 90 to 100 mm Hg range must obviously be reassessed. Various alt...Continue Reading

References

Jan 1, 1979·British Journal of Clinical Pharmacology·F A Finnerty
Jan 1, 1979·British Journal of Clinical Pharmacology·K O Stumpe, O Overlack
Sep 1, 1979·Journal of Cardiovascular Pharmacology·P Lund-Johansen
Oct 1, 1977·Circulation Research·P F Cranefield
Jun 11, 1977·British Medical Journal·G S StokesP R Davis
Jun 1, 1981·American Heart Journal·N M Kaplan
Apr 17, 1982·British Medical Journal·J L DayC N Simpson
Jun 5, 1982·British Medical Journal·A Lehtonen
May 1, 1982·Drugs·J A Whitworth, P Kincaid-Smith
Jul 1, 1981·Preventive Medicine·A W CaggiulaG Widdowson
Dec 1, 1981·Clinical Science·C T Dollery
Nov 1, 1981·Journal of Clinical Pharmacology·F H Messerli
Apr 1, 1981·The American Journal of Medicine·O B HollandL Kuhnert
Mar 1, 1981·Hypertension·M H Alderman, S Madhavan

❮ Previous
Next ❯

Citations

Feb 14, 1986·The American Journal of Medicine·M H Weinberger
Jul 1, 1987·Diabetes/metabolism Reviews·M F Lopes-Virella, J A Colwell
May 15, 2007·Current Opinion in Pediatrics·Mouin G Seikaly
Nov 7, 2003·The International Journal of Neuroscience·Myung-Suk LeeSun-Rock Moon
Feb 1, 1988·Drug Intelligence & Clinical Pharmacy·E A Jackson

❮ Previous
Next ❯

Related Concepts

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.

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.

Cardiovascular Diseases: Risk Factors

Cardiovascular disease is a significant health concern. Risk factors include hypertension, obesity, dyslipidemia and smoking. Women who are postmenopausal are at an increased risk of heart disease. Here is the latest research for risk factors of cardiovascular disease.