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 .
The Eurevie Study: contrasting effect of piretanide and thiazides in mild to moderate hypertension.
UNLABELLED This study compares the loop diuretic piretanide 6 mg in a slow-release formulation ( PIR ) with hydrochlorothiazide 25 mg ( HCT ) and the fixed combination altizide 15 mg-spironolactone 25 mg ( ALT-SP ) in hypertension . 1105 mild to moderate hypertensive patients entered a three-week placebo wash-out period ; 899 were r and omized in a 6-month , double-blind , parallel group treatment phase ; 800 completed the study . Primary end-points ; serum potassium concentration and quality of life at one month ; secondary end-points : ionic , renal and metabolic variables ; blood pressure ( BP ) measurements . HCT and ALT-SP were compared only to PIR using Dunnett 's or chi 2 tests . RESULTS No difference was found for the overall quality of life . No change of serum potassium concentration at one month was found in PIR while small decreases were detected with ALT-SP ( -0.1 mM ) and HCT ( -0.26 mM ) . Serum creatinine concentration increased significantly in ALT-SP when compared to PIR . All the drugs were effective in reducing BP : HCT had a higher rate of responders than PIR with similar mean BP falls and ALT-SP induced greater falls in blood pressure . CONCLUSION PIR proves to be a potent antihypertensive drug without significant effect on serum electrolytes , plasma glucose and lipids . HCT was slightly more potent but induced a fall in serum potassium concentration with a significant risk of hypokalaemia . The addition of SP to ALT led to a more potent diuretic with a higher level of serum potassium and plasma creatinine disturbances
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 .