Manisha Shahi. January 28, at pm. My mom is also taking hydrchlorthiazide.. March 16, at pm. Interesting point.
Sign In or Create an Account. Sign In. Advanced Search. Search Menu. Article Navigation. Close mobile search navigation Article Navigation. Volume Article Contents Disclosure. Carter , Barry L. Carver College of Medicine, University of Iowa. Carter barry. Oxford Academic. Michael E. Cite Cite Barry L. Select Format Select format. Permissions Icon Permissions. See other articles in PMC that cite the published article.
Randomized clinical trials in patients with hypertension and other cardiovascular disease CVD risk factors have shown that anti-hypertensive therapy with thiazide diuretics and beta-blockers is associated with increased incidence of new onset diabetes and other metabolic abnormalities 1 , 2.
There is growing evidence that those patients with central obesity and other components of the cardiometabolic syndrome are especially prone to new onset diabetes 1 5. Diuretics are medicines that are often used to treat high blood pressure.
They work on your kidneys by increasing the amount of salt and water that comes out through your urine. Too much salt can cause extra fluid to build up in your blood vessels, raising your blood pressure. Diuretics lower your blood pressure by flushing salt out of your body, taking this unwanted extra fluid with it. Diuretics also cause the walls of your blood vessel to relax and widen, which making it easier for your blood to flow through. This effect also lowers your blood pressure.
Most people who have high blood pressure will need to take one or more medicines to control it. Thiazide diuretics are a popular first-choice medicine for high blood pressure. They are particularly recommended for people who are over 55 or who are of African Caribbean origin. However, even if neither of these apply to you, you may be given a thiazide diuretic as a first choice. If you need to take more than one medicine to control your blood pressure enough, you may be given a diuretic as a second or third medicine.
Potassium-sparing diuretics may be used in people who have low potassium levels, because other diuretics can cause a drop in potassium levels. Hydrochlorothiazide with triamterene e. Hydrene Indapamide e. Natrilix, Dapa-Tabs, Insig Each of these drugs in different they are a different chemical substance but they way they work in the body is very similar, which is why we group them together as a class of drugs. As thiazide diuretics have a range of effects on the body, both in the kidney and on smooth muscles around the body, they can be used to treat several different health conditions.
Your doctor might have prescribed a thiazide diuretic for: Oedema build up of fluid with heart failure Oedema build up of fluid with hepatic cirrhosis Why do they help with these conditions? Lets take a closer look. The diuretic effect of thiazide diuretics is useful if you have oedema or nephrogenic diabetes insipidus.
In a healthy person, the kidneys constantly filter the blood in the body. Most of the blood enters into the nephrons everything except the big molecules like proteins and then your body reabsorbs the things you still need, like nutrients and fluids, back into your blood. In the end, only the things your body doesnt need make it to the end of the nephrons and are excreted in your urine. Thiazide diuretics change the reabsorption of certain things in your urine, making you urinate more often.
Specifically, they block sodium and chloride salts from being reabsorbed, which means more of these comes out in your urine. Water usually follows sodium in the body to dilute it so if more sodium is excreted, more fluid is excreted, causing the diuretic effect. There are also changes to the reabsorption of potassium and magnesium salts in the body.
Diuretics may increase diabetes risk by lowering blood potassium levels Posted on Nov 25, , 6 a. By Rich Hurd New research suggests that depleted blood potassium levels could help to explain why people prescribed diuretics for the treatment of high blood pressure are at increased risk of type 2 diabetes.
New research suggests that depleted blood potassium levels could help to explain why people prescribed diuretics for the treatment of high blood pressure are at increased risk of type 2 diabetes. Tariq Shafi and colleagues examined data from 3, non-diabetic participants in the Systolic Hypertension in Elderly Program SHEP , a study designed to determine the risk versus benefit of treating people age 60 years or older with the thiazide diuretic chlorthalidone.
Results of this study suggest that the increased risk of type 2 diabetes associated with thiazide diuretics is indeed linked to their action on blood potassium levels. When I started practicing, the starting dose of HCTZ was 50 mg daily and many were treated with mg daily. Lower doses became the norm years later. However, data have shown a dose-response relationship up to mg daily of HCTZ.
In one VA Cooperative Studies trial comparing propranolol to hydrochlorothiazide, the thiazide dose was started at 50 mg daily and increased at four-week intervals to mg and then mg daily. The largest response rate was at 50 mg and there was a difference between two and four weeks in lowering the BP at each dose.
The response rate was higher in Blacks than Whites. A comparison of lisinopril and hydrochlorothiazide in only obese patients mean weight 97 kg with men having mean kg and women 90 kg noted a dose-response in those responding to the drugs.
The HCTZ dose was I would not be adherent to recommendations for low doses in selected patients. NEJM ;
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