Moser Marvin, Feig Peter U
Department of Medicine, Yale University School of Medicine, 13 Murray Hill Rd, Scarsdale, NY 10583, USA.
Arch Intern Med. 2009 Nov 9;169(20):1851-6. doi: 10.1001/archinternmed.2009.342.
The use of thiazide diuretics has decreased over the past 30 years despite data from many well-controlled clinical trials demonstrating that the use of these agents as monotherapy or in combination with other antihypertensive agents will reduce blood pressure and decrease cardiovascular as well as cerebrovascular events.
We reviewed clinical and experimental data on thiazide diuretics since their introduction in the late 1950s.
The results of thiazide-based therapy in young and old are consistently positive despite concerns about some metabolic changes, eg, insulin resistance or hypokalemia, that may occur.
We conclude that these agents are safe, effective, and well tolerated and should continue to be used either as monotherapy or with other medications in the management of hypertension.
尽管许多严格控制的临床试验数据表明，噻嗪类利尿剂作为单一疗法或与其他抗高血压药物联合使用可降低血压并减少心血管和脑血管事件，但在过去30年中，其使用量仍有所下降。
我们回顾了自20世纪50年代末噻嗪类利尿剂问世以来的临床和实验数据。
尽管可能会出现一些代谢变化，如胰岛素抵抗或低钾血症，但基于噻嗪类的治疗在年轻人和老年人中的结果始终是积极的。
我们得出结论，这些药物安全、有效且耐受性良好，应继续作为单一疗法或与其他药物联合用于高血压的治疗。
