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European Heart Journal 1992 13(Supplement G):72-80; doi:10.1093/eurheartj/13.suppl_G.72
Copyright © 1992 by the European Society of Cardiology.
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© 1992 The European Society of Cardiology

Diuretics and cardiovascular risk factors

M. Moser

Yale University School of Medicine New Haven, Connecticut, U.S.A.

Correspondence: Marvin Moser, MD, FACP, Davis Avenue Medical Center, 33 Davis Avenue, White Plains, New York 10605, U.S.A.

Thiazide diuretics are efficacious, either as monotherapy or in combination with other antihypertensive drugs. They reduce blood pressure in a high percentage of hypertensive patients with minimal subjective side effects. There is increasing evidence that the use of diuretics, singly or in combination, will reduce morbidity and mortality associated with essential hypertension in both young and elderly subjects. Although diuretics may induce some changes in the plasma lipid profile, serum uric acid concentration and glucose metabolism, there is little evidence that these changes are of clinical significance. The increase in serum cholesterol concentration has rarely persisted in any trial beyond the first year of treatment. The incidence of diabetes mellitus in diuretic treated subjects is only about 1%, even when large doses are used. Gout may be precipitated in susceptible subjects, but is uncommon. For these reasons, diuretics should remain a preferred first-step drug of choice in the management of hypertension.

Key Words: Hypertension • diuretics • cardiovascular risk factors • clinical trials


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