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Am J Cardiol. 2011 Apr 15;107(8):1178-84. doi: 10.1016/j.amjcard.2010.12.016.

Evidence-based diuretic therapy for improving cardiovascular prognosis in systemic hypertension.

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Mid America Heart and Vascular Institute, Saint Luke's Hospital and University of Missouri-Kansas City, Kansas City, Missouri, USA.


Diuretics are among the most commonly prescribed cardiovascular (CV) medications. The strength of evidence supporting the effectiveness of diuretics in lowering blood pressure and for preventing major adverse CV events in patients with hypertension varies considerably among diuretic classes and even among agents within the same class. Unfortunately, common prescribing habits among American physicians, including specialists in CV diseases, are not in line with the existing evidence regarding diuretic therapy for improving CV prognosis. In conclusion, although hydrochlorothiazide is the standard diuretic used for hypertension, the outcomes data suggest that chlorthalidone, indapamide, and possibly even the aldosterone receptor blockers (spironolactone and eplerenone) may be superior agents.

[Indexed for MEDLINE]

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