Evidence for the efficacy of low-dose diuretic monotherapy

John M. Flack, William Cushman

Research output: Contribution to journalReview article

42 Citations (Scopus)

Abstract

Diuretic monotherapy has been recommended by the fifth report of the Joint National Committee on Detection, Evaluation and Treatment of High Blood Pressure (JNC-V) as a preferred initial treatment for hypertension. Thiazide diuretics are commonly used to treat hypertension because of their demonstrated efficacy, favorable safety profile, low acquisition cost, and their proven ability to reduce blood pressure-related morbidity and mortality. Once-daily low-dose hydrochlorothiazide (12.5 mg/day) or chlorthalidone (15 mg/day) effectively reduces blood pressure in patients with stage 1 or stage 2 hypertension in comparison with placebo. Blood pressure reductions with low-dose hydrochlorothiazide and chlorthalidone are comparable to that achieved with higher doses (25 and 50 mg/day). Additional blood pressure reductions can be attained with concomitant use of once-daily low-dose hydrochlorothiazide or chlorthalidone with an angiotensin-converting enzyme (ACE) inhibitor, a β blocker, or a calcium antagonist. Once-daily low-dose hydrochlorothiazide provides clinically meaningful blood pressure lowering while minimizing adverse effects, such as electrolyte disturbances, cholesterol elevations, and increases in serum uric acid levels.

Original languageEnglish (US)
Pages (from-to)53S-60S
JournalAmerican Journal of Medicine
Volume101
Issue number3 A
StatePublished - Sep 30 1996
Externally publishedYes

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Diuretics
Hydrochlorothiazide
Chlorthalidone
Blood Pressure
Hypertension
Sodium Chloride Symporter Inhibitors
Uric Acid
Angiotensin-Converting Enzyme Inhibitors
Electrolytes
Cholesterol
Placebos
Calcium
Morbidity
Safety
Costs and Cost Analysis
Mortality
Therapeutics
Serum

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Evidence for the efficacy of low-dose diuretic monotherapy. / Flack, John M.; Cushman, William.

In: American Journal of Medicine, Vol. 101, No. 3 A, 30.09.1996, p. 53S-60S.

Research output: Contribution to journalReview article

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