Anlauf Manfred
MMW Fortschr Med. 2007 Nov 15;149(46):31-3.
Diuretics are highly effective and are valuable antihypertensives in modern high blood pressure therapy. As a monotherapy, diuretics should be preferably be used in elderly patients; in a combination therapy, in any case in a triple combination therapy, they should be used regardless of the patient's age. Disadvantages include risk for developing hypokalaemia, their diabetogenicity with unclear long-term prognosis and the usually limited treatment persistence. Diuretics are no longer the lowest-priced antihypertensives. For monotherapy and dual combination therapy, effective alternatives are available. The necessity for the use of diuretics cannot be rationalized either medically or economically.
利尿剂疗效显著,在现代高血压治疗中是重要的降压药物。作为单一疗法,利尿剂更适合老年患者使用;在联合治疗中,尤其是三联联合治疗中,无论患者年龄如何都应使用。其缺点包括发生低钾血症的风险、致糖尿病性且长期预后不明以及治疗依从性通常有限。利尿剂已不再是价格最低的降压药物。对于单一疗法和双联联合治疗,有有效的替代药物。使用利尿剂的必要性在医学和经济方面都缺乏合理性。