Department of Pharmacology, Faculty of Medicine and Dentistry, Universitat de València, Spain.
Hipertens Riesgo Vasc. 2024 Jul-Sep;41(3):186-193. doi: 10.1016/j.hipert.2024.03.004. Epub 2024 Jun 9.
Diuretics have been used for decades in the treatment of hypertension. Its efficacy has been demonstrated in numerous clinical trials. It is well known that the reduction in cardiovascular risk is a consequence of the reduction in blood pressure levels regardless of the drug used, but thiazide diuretics continue to be first-line drugs, especially in low doses and combined with other drugs. The debate on the advantages of using chlorthalidone or hydrochlorothiazide continues, however hydrochlorothiazide is drug most used and for which there is greater availability. The association with potassium-sparing diuretics increases the effectiveness and reduces the adverse reactions of thiazides. A new group of drugs, close to potassium-sparing diuretics, that antagonise aldosterone synthase are showing promising results as antihypertensives. There are no significant differences between men and women regarding the antihypertensive effect of thiazide diuretics.
利尿剂在治疗高血压方面已经使用了几十年。它的疗效已在众多临床试验中得到证实。众所周知，无论使用何种药物，降低心血管风险都是血压水平降低的结果，但噻嗪类利尿剂仍然是一线药物，尤其是在低剂量时与其他药物联合使用。然而，关于使用氯噻酮或氢氯噻嗪的优势的争论仍在继续，因为氢氯噻嗪是使用最广泛且更易获得的药物。与保钾利尿剂联合使用可提高噻嗪类药物的疗效并减少不良反应。一组新的药物，接近保钾利尿剂，拮抗醛固酮合酶，作为抗高血压药物显示出有希望的结果。噻嗪类利尿剂对男性和女性的降压效果没有显著差异。
