Blog
About

0
views
0
recommends
+1 Recommend
1 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found

      Effect of Diuretics on Cardiac Arrhythmias and Left Ventricular Hypertrophy in Hypertension

      Cardiology

      S. Karger AG

      Diuretics, Hypertension, Arrhythmias, Left ventricular hypertrophy

      Read this article at

      ScienceOpenPublisherPubMed
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Ventricular arrhythmias pose a serious risk in patients with high blood pressure. The concept that diuretics predispose to life-threatening arrhythmias, however, was originally based solely on observations made in patients with severe congestive heart failure pretreated with digitalis and not in patients with high blood pressure. In hypertensive patients, some studies have also indicated that diuretic therapy may be associated with an increase in premature ventricular beats, though most have failed to demonstrate a conclusive link between hypokalemia and the precipitation of such cardiac arrhythmias. Prospective studies, however, have demonstrated that diuretic therapy had no effect on the incidence of serious ventricular arrhythmias in hypertensive patients whether they had left ventricular hypertrophy (LVH) or not, and neither at rest nor during or immediately following dynamic exercise. Correction of diuretic-induced hypokalemia similarly had no effect on the incidence of ventricular arrhythmias. In hypertensive patients, LVH is an independent and particularly sinister risk factor for cardiovascular morbidity and mortality, and its regression is now a specific goal of antihypertensive therapy. Diuretics have been shown to be at least as effective in that respect as other antihypertensive agents. The Veterans Administration Cooperative Study Group reported that after 2 years of treatment, only hydrochlorothiazide of 6 antihypertensive regimens resulted in significant reduction of left ventricular mass. In the Treatment of Mild Hypertension Study, all the antihypertensive drugs used resulted in reductions in LVH but the diuretic caused a significantly greater reduction than other non-diuretic agents. In the Systolic Hypertension in the Elderly Study, which primarily used diuretics, there was a significant reduction in LVH at 5 years. It is reasonable to conclude, therefore, that diuretics are safe and effective antihypertensive agents, which can no longer be considered arrhythmogenic and which induce LVH regression as effectively as other drugs.

          Related collections

          Author and article information

          Journal
          CRD
          Cardiology
          10.1159/issn.0008-6312
          Cardiology
          S. Karger AG
          978-3-8055-6001-6
          978-3-318-01948-3
          0008-6312
          1421-9751
          1994
          1994
          18 November 2008
          : 84
          : Suppl 2
          : 43-47
          Affiliations
          Department of Veterans Affairs, Medical Center and Georgetown University, Washington, D.C., USA
          Article
          176456 Cardiology 1994;84:43–47
          10.1159/000176456
          7954545
          © 1994 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Pages: 5
          Categories
          Hypertension: Session II

          Comments

          Comment on this article