Why are physicians not prescribing diuretics-more frequently in the management of hypertension ?
Diuretics have again been recommended by the Sixth Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI) as one of the first-choice medications in the management of hypertension.
This recommendation is based on the results of numerous randomized, diuretic-based, long-term controlled clinical trials that have demonstrated a reduction in both cerebrovascular and cardiovascular morbidity.
Despite this and other national recommendations, the use of diuretics has steadily decreased over the past 15 years.
Reasons include heavy promotion of other medications and the perception that diuretics produce adverse metabolic effects and do not reduce coronary heart disease events.
Data, however, indicate that (1) changes in glucose and cholesterol metabolism are minor, especially with the smaller doses now being used ; (2) cardiovascular morbidity and mortality have been reduced in hypertensive patients, even in those with hyperlipidemia or diabetes, when diuretics are used ; and (3) concerns about hypokalemia-induced arrhythmias have been overstated. (...)
Mots-clés Pascal : Hypertension artérielle, Evaluation, Prescription médicale, Diurétique, Etiologie, Facteur risque, Recommandation, Médecin, Homme, Appareil circulatoire pathologie, Chimiothérapie
Mots-clés Pascal anglais : Hypertension, Evaluation, Medical prescription, Diuretic, Etiology, Risk factor, Recommendation, Physician, Human, Cardiovascular disease, Chemotherapy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0321776
Code Inist : 002B02F09. Création : 27/11/1998.