Differences in antihypertensive effect were due to potency rather than efficacy .
This synthesis accomplishes for PSDs what has already been achieved for thiazide-type diuretics and other antihypertensives and can guide the application of these underutilized medicines
BACKGROUND Potassium-sparing diuretics ( PSDs ) are valuable antihypertensives with additional benefits unrelated to control of systolic blood pressure ( SBP ) .
However , their key parameters affecting SBP and serum potassium are poorly defined , fostering underutilization .
Ventricular ectopic activity with diuretic therapy.
The arrhythmogenic potential of diuretic-induced hypokalemia in patients with uncomplicated hypertension has been controversial . Thirty-two hypertensive patients with previous diuretic-induced hypokalemia , normal 24-hour ambulatory ECG monitoring , and normal exercise testing were treated with 100 mg hydrochlorothiazide ( HCTZ ) daily ( Group 1 ) to induce hypokalemia or with a combination of HCTZ with amiloride ( Group 2 ) to attempt to maintain plasma potassium levels in the normal range during diuretic therapy . Those Group 1 patients ( Group 1A ) with increased ventricular ectopic activity ( VEA ) during HCTZ therapy were subsequently potassium-repleted with amiloride and with supplemental potassium chloride to evaluate the effect of these treatments on VEA . One Group 1 patient died suddenly after 12 days of HCTZ therapy . Autopsy findings suggested an arrhythmic death . Six Group 1 patients who had increased VEA with HCTZ treatment had reductions in VEA with amiloride or supplemental potassium chloride . Group 2 patients did not have a significant increase in VEA . Thus , diuretic therapy appears to cause VEA primarily by electrolyte changes that are induced
Differences in antihypertensive effect were due to potency rather than efficacy .
This synthesis accomplishes for PSDs what has already been achieved for thiazide-type diuretics and other antihypertensives and can guide the application of these underutilized medicines
BACKGROUND Potassium-sparing diuretics ( PSDs ) are valuable antihypertensives with additional benefits unrelated to control of systolic blood pressure ( SBP ) .
However , their key parameters affecting SBP and serum potassium are poorly defined , fostering underutilization .