Diuretics For Hypertension: Goals, Types, Usage, and Side Effects – Hypertension is a condition where systolic blood pressure is 140 mmHg or more and diastolic pressure 90 mmHg or more and measured more than one.
Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC) VII classify blood pressure for ages 18 and above into four groups based on systolic/diastolic blood pressure which is
- Normal blood pressure (< 120/< 80),
- Prehypertension (120-139/80-89),
- Level 1 hypertension (140-159/90-99), and
- Level 2 hypertension (≥ 160/≥ 100).
Patients whose blood pressure is in the category of prehypertension have twice greater risk of hypertension than those with more blood pressure.
One of the most frequent treatments for high blood diseases is diuretics. Have you ever listened to it? Otherwise, you should listen to this one.
Treatment through this diuretic to overcome excess levels of salt and water in the body. Diuretic therapy is the most widely done by people with a high blood pressure disease that is also done for heart attack and diabetes.
Many diseases are caused by the rise of blood pressure. While the application of diuretic therapy is also combined with the use of several drugs related to high blood pressure.
Goals and objectives of Diuretics For Hypertension therapy
The purpose of treatment of hypertension is to prevent the occurrence of cardiovascular morbidity and mortality due to high blood pressure in ways to a minimum to interfere with the patient’s quality of life. This is achieved by achieving and maintaining blood pressure under 140/90 mmHg while controlling other cardiovascular risk factors.
Even some research results also show that diuretic therapy is also very potent to prevent the occurrence of stroke diseases, heart attacks, diabetes, as well as kidney failure diseases.
Pharmaceutical Diuretics Types
Prescription diuretic medications are grouped into three main types.
Thiazide diuretics help treat hypertension by causing dilated blood vessels and the body to remove extra fluids. Examples of thiazides include Metolazone (Zaroxolyn), Indapamide (Lozol), and Hydrochlorothyazides (Microzide).
The loop diuretic removes excess fluid by causing the kidneys to produce more urine. This includes furosemide (Lasix), ethacrynic acid (Edecrin), and Torsemide (Demadex).
Potassium-sparing diuretics encourage the body to get rid of liquids and sodium. However, they do this without causing the loss of potassium, which is an essential nutrient. Examples of potassium-sparing diuretics include triamterene (Dyrenium), Eplerenon (Inspra), and Spironolactone (Aldactone).
Aldosterone antagonist (Spironolakton)
The aldosterone antagonist (Spironolakton) can be considered more potent with the start of a slow work (up to 6 weeks for Spironolakton). However, JNC 7 sees it as an independent class because the evidence supports special indications.
Mechanism of action of drugs
What is the mechanism of antihypertensive drugs?
By increasing the volume of urine so that the salt in the urine can be removed, because we know that salt can increase blood pressure, diuretics also cause the volume of urine to be reduced, so that the volume of blood fluid in the body decreases which has the decrease in blood pressure.
How should You use it?
Diuretics usually used once a day in the morning, do not use at night because can interfere with the effect of the drug that causes us to be frequent urination.
Diuretics For Hypertension Side Effects
Diuretics are generally safe, but they have some side effects, such as increased urination and mineral loss.
This medication may also affect blood potassium levels. You can develop too much potassium (hyperkalemia) If you consume a type of potassium sparing diuretics or too little potassium (hypokalemia) If you consume thiazide diuretics.
Side effects of thyazide include hypokalemia, Hypomagnesia, Hypercalcemia, hyperuricemia, Hyperglycemia, hyperlipidemia, and se**xual dysfunction. Short-term studies suggest that indapamide does not affect fats or glucose or se**xual dysfunction.
All of the above side effects are associated with dosage. Most of these side effects are identified with the high dose tiazide administration (e.g. HCT 100 mg/day). Guidelines now suggest a dose of HCT or Chlortalidone of 12.5 – 25 mg/day, wherein the metabolic side effects will be greatly reduced.
A loop diuretic can cause similar side effects, although the effects on serum fat and glucose are not so meaningful, and sometimes hypocalcemia can occur.
Potassium-Sparing diuretics can cause hyperkalemia, especially in patients with chronic kidney disease or diabetes and in patients receiving ACE inhibitors, ARB, NSAIDS, or potassium supplements.
Other side effects that may arise from diuretics include:
- Low sodium in your blood (hyponatremia)
- Muscle cramps
- Joint disorders (gout)
Read also: Kinds of Tea For High Blood Pressure.
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