We found no clinical ly meaningful blood pressure-lowering differences between different drugs within the loop diuretic class .
BACKGROUND Antihypertensive drugs from the thiazide diuretic drug class have been shown to reduce mortality and cardiovascular morbidity .
Loop diuretics are indicated and used to treat hypertension , but a systematic review of their blood pressure-lowering efficacy or effectiveness in terms of reducing cardiovascular mortality or morbidity from r and omized controlled trial ( RCT ) evidence has not been conducted .
OBJECTIVES To determine the dose-related decrease in systolic or diastolic blood pressure , or both , as well as adverse events leading to participant withdrawal and adverse biochemical effects ( serum potassium , uric acid , creatinine , glucose and lipids profile ) due to loop diuretics versus placebo control in the treatment of people with primary hypertension .
Neurohormonal effects of furosemide withdrawal in elderly heart failure patients with normal systolic function.
BACKGROUND In heart failure patients , diuretics cause renin-angiotensin-aldosterone system ( RAS ) activation , which may lead to increased morbidity and mortality despite short-term symptomatic improvement . AIM To determine changes in RAS activation and clinical correlates following furosemide withdrawal in elderly heart failure patients without left ventricular systolic dysfunction . METHODS AND RESULTS We performed clinical assessment s and laboratory determinations of aldosterone , plasma renin activity ( PRA ) , atrial natriuretic peptide ( ANP ) , norepinephrine , and endothelin in 29 heart failure patients [ aged 75.1+/-0.7 ( mean+/-S.E.M. ) years ] , before , 1 and 3 months after placebo-controlled furosemide withdrawal .  Recurrent congestion occurred in 2 of 19 patients withdrawn , and in 1 of 10 patients continuing on furosemide . Three months after withdrawal , PRA had decreased -1.61+/-0.71 nmol/l/h ( P<0.05 ) . Decreases in aldosterone levels did not reach significance ( -0.17+/-0.38 nmol/l ) . The decreases in PRA after withdrawal correlated with decreases in systolic ( r(s)=0.61 , P=0.020 ) and diastolic blood pressure ( r(s)=0.80 , P=0.01 ) . Successful withdrawal was associated with increases in norepinephrine ( + 0.58+/-0.22 nmol/l ) and ANP ( + 3.5+/-1.3 pmol/l ) ( P<0.05 ) after 1 month , but these changes did not persist after 3 months . Endothelin levels did not change in both groups . CONCLUSION Successful furosemide withdrawal in elderly heart failure patients causes persistent decreases in RAS activation
We found no clinical ly meaningful blood pressure-lowering differences between different drugs within the loop diuretic class .
BACKGROUND Antihypertensive drugs from the thiazide diuretic drug class have been shown to reduce mortality and cardiovascular morbidity .
Loop diuretics are indicated and used to treat hypertension , but a systematic review of their blood pressure-lowering efficacy or effectiveness in terms of reducing cardiovascular mortality or morbidity from r and omized controlled trial ( RCT ) evidence has not been conducted .
OBJECTIVES To determine the dose-related decrease in systolic or diastolic blood pressure , or both , as well as adverse events leading to participant withdrawal and adverse biochemical effects ( serum potassium , uric acid , creatinine , glucose and lipids profile ) due to loop diuretics versus placebo control in the treatment of people with primary hypertension .