Medications for hypertension with a diuretic effect

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Medications for hypertension with a diuretic effect

Medications for hypertension with a diuretic effect


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Medications for hypertension with a diuretic effect: diuretics in the treatment of Arterial hypertension Arterial hypertension, also known as hypertension, is a worldwide health problem and is considered an important risk factor for cardiovascular disease, including heart attack, stroke and kidney failure. Effective blood pressure control is, therefore, of crucial importance for the prevention of these complications. An important group of drugs for the treatment of high blood pressure, diuretics, also known as a diuretic agent. Their effect is based on the increase in the excretion of water and electrolytes (especially sodium and potassium) on the kidney, which leads to a reduction of the blood volume and thus to a Lowering of blood pressure. The main types of diuretics in hypertension In the therapy of arterial hypertension in front of all three classes of diuretics are used: Thiazide diuretics (e.g. hydrochlorothiazide): they act in the distal duct of the kidney and are often the first choice for the initial treatment of moderate hypertension. They are characterized by a sufficient effectiveness, and cost effectiveness. Loop diuretics (e.g., furosemide): These funds have a stronger effect and are used especially in patients with impaired renal function or heart failure. Their site of action is the loop of Henle. Potassium-saving diuretics (e.g., spironolactone, amiloride): you can prevent excessive loss of Potassium and are often administered in combination with other diuretics in order to electrolyte balance disorders. Spironolactone antagonists also belongs to the group of mineralocorticoid receptor and, in addition, shows anti‑fibrotic and anti‑inflammatory effects. Mechanism of action The blood pressure lowering effect of diuretics can be divided into two phases: Acute reduction in intravascular volume due to increased urine output (diuresis), which leads to a drop in Cardiac output. Long-term: decrease in peripheral Vascular resistance, probably due to a reduction in the sodium accumulation in the smooth muscles of the vascular wall. Clinical aspects and Monitoring In the application of diuretics periodic monitoring of electrolytes (especially Na + , K + ), the kidneys value (creatinine, eGFR) and blood sugar (in patients with diabetes risk) is required. Possible side effects include: Hypokalemia (especially Thiazides and loop diuretics), Hyperkalemia (potassium-sparing diuretics, especially in combination with ACE inhibitors or ARB), Uric acid increase and trigger attacks of Gout, Disorders of Lipid and glucose metabolism. Conclusion Diuretics play a Central role in the pharmacotherapy of arterial hypertension. Due to their proven efficacy in reducing blood pressure and the reduction of cardiovascular events, they are considered an essential component of long-term therapy. The individual choice of the Diuretic should always be carried out under consideration of renal function, electrolyte substance, and the present co-morbidities. A combined therapy with other antihypertensives (e.g., ACE inhibitors, calcium antagonists) often allows optimal blood pressure control with minimal side-effect profile.

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