The role of diuretics in the treatment of hypertension: a focus on chlorthalidone (lecture)
Keywords:diuretics, arterial hypertension, treatment, chlorthalidone
The lecture discusses the role of thiazide and thiazide-like diuretics, in particular chlorthalidone, in the modern treatment of arterial hypertension. The modern concepts about the mechanism of action of thiazide diuretics and chlorthalidone are presented. Differences in the degree of antihypertensive effect of hydrochlorothiazide and chlorthalidone are discussed. The results of large randomized trials SHEP, MRFIT, ALLHAT were analyzed, in which chlorthalidone therapy significantly reduced the risk of developing cardiovascular and cerebrovascular complications of hypertension. The effect of thiazide diuretics on glucose metabolism and the impact of carbohydrate metabolism disorders during treatment with chlorthalidone on the risk of cardiovascular complications was considered. The lecture also discusses the effect of chlorthalidone therapy on kidney function, the possibility of its use in chronic kidney disease. The data are presented on the prevention of resistant hypertension and chro-nic heart failure during long-term therapy of hypertension with chlorthalidone. The frequency and terms of the development of side effects of hypertension therapy with thiazide-like diuretics were also analyzed.
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