page_title: Antihypertensive drug
section_title: Diuretics
hierarchical_section_title: Antihypertensive drug / Diuretics
context_page_description: Antihypertensives are a class of drugs that are used to treat hypertension. Antihypertensive therapy seeks to prevent the complications of high blood pressure, such as stroke and myocardial infarction. Evidence suggests that reduction of the blood pressure by 5 mmHg can decrease the risk of stroke by 34%, of ischaemic heart disease by 21%, and reduce the likelihood of dementia, heart failure, and mortality from cardiovascular disease. There are many classes of antihypertensives, which lower blood pressure by different means. Among the most important and most widely used medications are thiazide diuretics, calcium channel blockers, ACE inhibitors, angiotensin II receptor antagonists, and beta blockers.
  Which type of medication to use initially for hypertension has been the subject of several large studies and resulting national guidelines. The fundamental goal of treatment should be the prevention of the important endpoints of hypertension, such as heart attack, stroke and heart failure. Patient age, associated clinical conditions and end-organ damage also play a part in determining dosage and type of medication administered.
context_section_description: Diuretics help the kidneys eliminate excess salt and water from the body's tissues and blood.
  Loop diuretics:
  bumetanide
  ethacrynic acid
  furosemide
  torsemide
  Thiazide diuretics:
  epitizide
  hydrochlorothiazide and chlorothiazide
  bendroflumethiazide
  methyclothiazide
  polythiazide
  Thiazide-like diuretics:
  indapamide
  chlorthalidone
  metalozone
  Xipamide
  Clopamide
  Potassium-sparing diuretics:
  amiloride
  triamterene
  spironolactone
  eplerenone
  In the United States, the JNC8 (Eighth Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure) recommends thiazide-type diuretics to be one of the first-line drug treatments for hypertension, either as monotherapy or in combination with calcium channel blockers, ACE inhibitors, or  angiotensin II receptor antagonists. There are fixed-dose combination drugs, such as ACE inhibitor and thiazide combinations. Despite thiazides being cheap and effective, they are not prescribed as often as some newer drugs. This is because they have been associated with increased risk of new-onset diabetes and as such are recommended for use in patients over 65 where the risk of new-onset diabetes is outweighed by the benefits of controlling systolic blood pressure. Another theory is that they are off-patent and thus rarely promoted by the drug industry.
caption: Hydrochlorothiazide, a popular thiazide diuretic
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