Seminars in Nephrology
Volume 31, Issue 6 , Pages 495-502, November 2011

Diuretics in the Treatment of Hypertension

  • Michael E. Ernst, PharmD

      Affiliations

    • Department of Pharmacy Practice and Science, College of Pharmacy, and Department of Family Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA
    • Corresponding Author InformationAddress reprint requests to Michael E. Ernst, PharmD, Department of Family Medicine, 01291-A/PFP, University of Iowa Hospitals and Clinics, 200 Hawkins Dr, Iowa City, IA 52242
  • ,
  • Samuel J. Mann, MD

      Affiliations

    • Department of Medicine, Division of Nephrology and Hypertension, New York Presbyterian Hospital, Weill Cornell Medical Center, New York, NY

Summary 

Diuretics are powerful agents that impair sodium reabsorption in renal tubules. Their ability to alter long-term sodium balance induces important hemodynamic changes that result in a reduction in peripheral resistance and sustained reduction in blood pressure. A pharmacologically diverse group of drugs, they remain a mainstay in the therapy of hypertension. Clinical trials over the past 4 decades consistently have shown that blood pressure lowering obtained from a diuretic-based regimen reduces cardiovascular events. The ability of diuretics to augment the efficacy of nearly all other classes of antihypertensives makes them highly versatile and an important pharmacotherapeutic intervention to achieve blood pressure control. This article reviews key aspects of the use of diuretics relevant to the clinical management of hypertension.

Keywords: Diuretics, thiazide, loop, potassium-sparing, hypertension

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PII: S0270-9295(11)00133-1

doi:10.1016/j.semnephrol.2011.09.004

Seminars in Nephrology
Volume 31, Issue 6 , Pages 495-502, November 2011