Skip Navigation


European Heart Journal Advance Access originally published online on February 13, 2006
European Heart Journal 2006 27(7):886-887; doi:10.1093/eurheartj/ehi782
This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
27/7/886-b    most recent
ehi782v1
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Jolobe, O. M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Jolobe, O. M.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The European Society of Cardiology 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Diuretic usage in heart failure: a continuing conundrum in 2005

Oscar M. Jolobe

Manchester medical Society
Medical Division
1 The Lodge
842 Wilmslow Road
Didsbury
Manchester
Lancashire M20 2RN
UK
Tel: +44 1614489034
E-mail address: oscarjolobe{at}yahoo.co.uk

Notwithstanding the fact that the use of low-dose diuretics (overwhelmingly thiazides) in anti-hypertensive regimes has been associated with a risk reduction of the order of 0.51 (95% confidence interval 0.42–0.62) in the incidence of congestive heart failure,1 the absence of scrutiny of these drugs, to which the authors allude,2 has also included the failure to address the issue of whether the anti-hypertensive efficacy of long-acting loop diuretics such as torasemide might be comparable to that of thiazides, and whether, for both classes of drugs, the anti-hypertensive efficacy might be solely attributable to sustained natriuresis. A related issue is whether the protection that thiazides confer against hypertension-related heart failure might be rivalled, if not surpassed, by diuretics such as torasemide, which potentially possess cardioprotective properties by virtue of additional anti-aldosteronergic effects.3 The time is long overdue for these issues to be addressed, given the inescapable risk of hyponatraemia (including severe hyponatraemia) inherent in the use of thiazides,4–6 by virtue of their physiological actions on the renal tubule and collecting ducts.6

References

  1. Psaty BM, Lumley T, Furberg CD, Schellenbaum G, Pahor M, Alderman MH, Weiss NS. Health outcomes associated with various antihypertensive therapies used as first-line agents. J Am Med Assoc 2003;289:2534–2544.[Abstract/Free Full Text]
  2. Gupta S, Neyses L. Diuretic usage in heart failure: a continuing conundrum in 2005-08-21. Eur Heart J 2005;26:644–649.[Abstract/Free Full Text]
  3. Uchida T, Yamanage K, Nishikawa M, Ohtaki Y, Kido H, Wanatabe M. Anti-aldosteronergic effect of torasemide. Eur J Pharamacol 1991;205:145–150.[CrossRef][Web of Science][Medline]
  4. Sharabi Y, Illan R, Kamari Y, Cohen H, Nadler M, Messerli FH, Grossman E. Diuretic induced hyponatraemia in elderly hypertensive women. J Human Hypertens 2002:16:631–635.[CrossRef][Web of Science][Medline]
  5. SHEP Cooperative Research Group. Prevention of stroke by antihypertensive drug treatment in older persons with isolayed systolic hypertension. Final results of the Systolic Hypertension in the Elderly Program (SHEP). J Am Med Assoc 1994;265:3255–3264.
  6. Sonnenblick M, Friedlander Y, Rosin AJ. Diuretic-induced severe hyponatraemia. Review and analysis of 129 reported patients. Chest 1993;103:601–606.

Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?



This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
27/7/886-b    most recent
ehi782v1
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Jolobe, O. M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Jolobe, O. M.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?