Strategies to improve the cardiovascular risk profile of thiazide-type diuretics as used in the management of hypertension

Expert Opinion on Drug Safety
Barry L Carter, Domenic A Sica


Thiazide diuretics are one of the preferred pharmacologic treatments for hypertension. However, there has been rather pointed debate during the past 20 years about the clinical significance of the biochemical and/or metabolic adverse effects caused by diuretics. This controversy centers around whether the hypokalemia, hypomagnesemia, hyperuricemia, hyperglycemia and/or hyperlipidemia occasionally seen with diuretics might lessen some of the beneficial effects on cardiovascular risk seen with reductions in blood pressure. One of the biggest controversies in the last few years has focused on whether the small increase in absolute risk of diabetes seen with diuretic therapy should be a concern. The vigilant clinician should appropriately dose and monitor diuretic therapy either when given alone or when used in combination therapy. When these strategies are employed, the adverse effects seen with diuretics can be minimized or negated, and in so doing cardiovascular benefits can be optimized.


Nov 1, 1977·Clinical Pharmacology and Therapeutics·M G TweeddaleJ Ruedy
Aug 1, 1978·Clinical Pharmacology and Therapeutics·B J MatersonJ H Morledge
May 31, 1978·European Journal of Clinical Pharmacology·B Beermann, M Groschinsky-grind
Oct 30, 1976·The Medical Journal of Australia·S CarneyT Morgan
Feb 1, 1975·The Journal of Clinical Investigation·E J WeinmanW N Suki
Jun 1, 1988·Archives of Internal Medicine·V PapademetriouE D Freis
Jan 1, 1986·Drugs·P Leren, A Helgeland
Jan 1, 1987·European Journal of Clinical Pharmacology·G CoccoH R Baumeler
Jun 1, 1988·Archives of Internal Medicine·C K Lardinois, S L Neuman
Apr 1, 1988·JAMA : the Journal of the American Medical Association·J WikstrandG Berglund
Jul 1, 1987·The Western Journal of Medicine·E B FlinkW E Wacker
Mar 1, 1986·Clinical Pharmacology and Therapeutics·E D Freis
Mar 1, 1986·Journal of the American Geriatrics Society·J H MorledgeM Davidov
Apr 1, 1986·Journal of Hypertension·B F JohnsonJ Johnson
Oct 1, 1987·Archives of Internal Medicine·B J Martin, K Milligan
Mar 21, 1985·The New England Journal of Medicine·N M KaplanM Simmons
May 1, 1973·Acta Medica Scandinavica·B DegnbolT Marner
Sep 1, 1970·Clinical Pharmacology and Therapeutics·P J McLeodJ Ruedy
Oct 1, 1984·Human Toxicology·A J Reyes, W P Leary
Dec 1, 1983·British Heart Journal·J E Nordrehaug, G von der Lippe
Apr 1, 1981·The American Journal of Medicine·O B HollandL Kuhnert
Mar 29, 1980·British Medical Journal·D B Morgan, C Davidson


Apr 27, 2012·The Journal of Clinical Hypertension·Barry L Carter

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