Materson Barry J
Division of Nephrology and Hypertension, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA.
J Am Soc Hypertens. 2007 Nov-Dec;1(6):373-80. doi: 10.1016/j.jash.2007.06.007.
In the 50 years since the introduction of cholorothiazide by Fries and Wilson for the treatment of hypertension, numerous thiazide and thiazide-like diuretics have been marketed. Orally-administered diuretics enhanced the therapeutic efficacy of extant antihypertensive medications and reduced the doses required; adverse effects were thereby reduced as well. Initially, high doses of diuretics were employed at least in part because of the misconception that substantial natriuresis was required for their antihypertensive effect. As the long-term vasodilating effects of the thiazides became appreciated, it was possible to separate antihypertensive dose-response from natriuretic dose-response. As ever lower doses of thiazides were proven to be effective, most of their associated biochemical side and adverse effects were also reduced. Fifty years later, thiazide diuretics maintain a key role in the treatment of hypertension-especially in combination with one or more non-diuretic drugs.
自弗里斯（Fries）和威尔逊（Wilson）引入氯噻嗪用于治疗高血压以来的50年里，众多噻嗪类和类噻嗪类利尿剂已投放市场。口服利尿剂提高了现有抗高血压药物的治疗效果，并减少了所需剂量；不良反应也因此减少。最初，使用高剂量利尿剂至少部分是因为误解，即认为其降压作用需要大量利钠作用。随着噻嗪类药物长期血管舒张作用得到认识，有可能将降压剂量反应与利钠剂量反应区分开来。随着越来越低剂量的噻嗪类药物被证明有效，其相关的大多数生化副作用和不良反应也减少了。50年后，噻嗪类利尿剂在高血压治疗中仍发挥着关键作用，尤其是与一种或多种非利尿剂药物联合使用时。
