Thiazide and thiazide-like diuretics have been widely used as blood pressure-lowering agents for more than 5 decades. However, their use in patients with advanced chronic kidney disease has been limited and often discouraged. The exact mechanism of how thiazide and thiazide-like diuretics lower blood pressures is still in question. Emerging evidence suggests that thiazides and thiazide-like diuretics are effective as blood pressure-lowering drugs in patients with advanced chronic kidney disease. Review of the literature suggests that physicians should not discard thiazide and thiazide-like diuretics as options for blood pressure management in patients with chronic advanced kidney disease.
Treatment of hypertension in the elderly. III. Response of isolated systolic hypertension to various doses of hydrochlorothiazide: results of a Department of Veterans Affairs cooperative study. Department of Veterans Affairs Cooperative Study Group on Antihypertensive Agents
Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. Final results of the Systolic Hypertension in the Elderly Program (SHEP). SHEP Cooperative Research Group
Antihypertensive and biochemical effects of different doses of hydrochlorothiazide alone or in combination with triamterene
Beneficial effects from systematic dosage reduction of the diuretic, chlorthalidone: a randomized study within a clinical trial
Hemodynamic changes during long-term thiazide treatment of essential hypertension in responders and nonresponders
Penbutolol or hydrochlorothiazide once a day in hypertension. A controlled study with home measurements
Sympathetic and parasympathetic components of reflex cardiostimulation during vasodilator treatment of hypertension
Diuretic effectiveness of hydrochlorothiazide and furosemide alone and in combination in chronic renal failure
Health outcomes associated with antihypertensive therapies used as first-line agents. A systematic review and meta-analysis
Second Australian National Blood Pressure Study (ANBP2). Australian Comparative Outcome Trial of ACE inhibitor- and diuretic-based treatment of hypertension in the elderly. Management Committee on behalf of the High Blood Pressure Research Council of Australia
Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT)
Effects of reduced glomerular filtration rate on responsiveness to chlorothiazide and mercurial diuretics
Influence of chlorothiazide upon arterial responsiveness to nor-epinephrine in hypertensive subjects
Relationship between plasma and extracellular fluid volume depletion and the antihypertensive effect of chlorothiazide
Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure
Thiazide-like diuretics attenuate agonist-induced vasoconstriction by calcium desensitization linked to Rho kinase
A randomized trial of furosemide vs hydrochlorothiazide in patients with chronic renal failure and hypertension
Mechanisms for blood pressure lowering and metabolic effects of thiazide and thiazide-like diuretics
Chlorthalidone reduces cardiovascular events compared with hydrochlorothiazide: a retrospective cohort analysis
A pilot study comparing furosemide and hydrochlorothiazide in patients with hypertension and stage 4 or 5 chronic kidney disease
Meta-analysis of dose-response relationships for hydrochlorothiazide, chlorthalidone, and bendroflumethiazide on blood pressure, serum potassium, and urate
Tag polymorphisms of solute carrier family 12 member 3 gene modify the risk of hypertension in northeastern Han Chinese
Antihypertensive therapy prescribing patterns and correlates of blood pressure control among hypertensive patients with chronic kidney disease
A Randomized Trial of Distal Diuretics versus Dietary Sodium Restriction for Hypertension in Chronic Kidney Disease.
Effect of diuretics on plasma renin activity in primary hypertension: A systematic review and meta-analysis.
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.