caa a22 4500 475833678 CHVBK 20180406123848.0 cr unu---uuuuu 170329e20000601xx s 000 0 eng 10.1023/A:1007864216398 doi (NATIONALLICENCE)springer-10.1023/A:1007864216398 Opie Lionel Heart Research Unit, Cape Heart Centre, University of Cape Town Medical School, Cape Town, South Africa aut Diuretic Downsides—But in Low Doses They Still Seem Among the Best Authenticated Antihypertensives [Elektronische Daten] [Lionel Opie] Diuretics in low doses have the greatest support among current available antihypertensives in that they have been shown to reduce total mortality, coronary mortality, stroke, and congestive heart failure in an important meta-analysis by Psaty. Recently, Messerli has linked long-term diuretic use to renal cell carcinoma in women. In some patients, diuretic use leads to increasing blood cholesterol and blood sugar levels. Impotence is a recognized side effect, with rates rising about twofold with low-dose chlorthalidone and fourfold with a higher dose. Certain population groups such as younger (<60 years) white males often do not respond to low-dose diuretic therapy with an adequate blood pressure fall. In females of a similar age group, Messerli calculates that prolonged diuretic therapy will prevent only one stroke and no coronary events nor any deaths for every renal cell carcinoma that is provoked. Despite these evident problems, the outcome data on hard endpoints in trials with initial low-dose diuretic therapy remain valid and convincing. Thus, it is argued, low- but not high-dose diuretics retain their primacy in the ranking of antihypertensive therapy. Kluwer Academic Publishers, 2000 diuretics nationallicence hypertension nationallicence low dose nationallicence cancer nationallicence cholesterol nationallicence Cardiovascular Drugs and Therapy Kluwer Academic Publishers 14/4(2000-06-01), 407-409 0920-3206 14:4<407 2000 14 10557 https://doi.org/10.1023/A:1007864216398 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1023/A:1007864216398 text/html Onlinezugriff via DOI NATIONALLICENCE 100 1- Opie Lionel Heart Research Unit, Cape Heart Centre, University of Cape Town Medical School, Cape Town, South Africa aut NATIONALLICENCE 773 0- Cardiovascular Drugs and Therapy Kluwer Academic Publishers 14/4(2000-06-01), 407-409 0920-3206 14:4<407 2000 14 10557 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer