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 .
Effects of angiotensin and angiotensin blockade on coronary circulation and coronary reserve.
Angiotensin is a potent coronary vasoconstrictor , but little is known of the effects of long-term activation of the renin-angiotensin system on coronary reserve in humans . The effects of exercise on coronary hemodynamics were determined in eight patients with mild essential uncomplicated hypertension , before and after treatment with furosemide ( 50 mg , to ensure activation of the renin-angiotensin system ) . Coronary sinus blood flow was measured by thermodilution technique , intra-arterial blood pressure was measured from the ascending aorta , and plasma renin activity was determined by radioimmunoassay . Oxygen supply and dem and were derived ( using coronary sinus blood flow multiplied by the arteriovenous oxygen difference to equal oxygen supply and heart rate multiplied by the mean systolic blood pressure to equal oxygen dem and ) both at rest and during isometric exercise ( h and grip to 50 percent of maximal effort for three minutes ) . The study was a single-blind crossover ( furosemide versus placebo ) design . Furosemide produced a significant reduction in coronary sinus blood flow , associated with an increase in coronary vascular resistance . Changes in mean arterial pressure and heart rate were insignificant . Slight reductions in plasma volume and mean right atrial pressure were observed . During isometric exercise , the increase in oxygen supply for a given increment in oxygen dem and was attenuated by furosemide . The contribution of the renin-angiotensin system to this effect was determined by the short-term administration of 25 mg of the angiotensin converting enzyme inhibitor captopril . Forty-five minutes after oral captopril , coronary reserve was restored to pretreatment values . In conclusion , furosemide modulates coronary reserve , and it is likely that this is because furosemide mediates activation of renin-angiotensin system , thus reducing the vasodilatory capacity of the coronary arteries
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 .