A study of certain representative diuretics on renal function, as measured by the urea clearance test, has been undertaken to determine whether these substances have an accelerating or retarding action on the excretion of urea. Practically, it seemed important to know whether studies of kidney function may be carried out, without interference, during the often necessary administration of diuret...

Loop diuretics are used in patients with heart failure (HF) to relieve symptoms of systemic and pulmonary venous congestion. Despite their nearly universal use for this indication, loop diuretics have not been shown to improve survival—indeed, a number of recent studies suggest an adverse relationship between the use of loop diuretics and survival (1–3). This is plausible because loop diuretics...

Diuretics (see Table 1.1 for a physiological classification) remain an important part of the medical therapy for patients with congestive heart failure (CHF). They control fluid retention and rapidly relieve the congestive symptoms of heart failure (HF). The American College of Cardiology/American Heart Association assigned them a class I indication in patients with symptomatic heart failure wh...

MAIN RESULTS Over 10 years, 413 people (4%) receiving continuous treatment with lithium were admitted into hospital at least once for lithium toxicity. Of these, 15% required critical care, 3% dialysis, and 5% died before discharge. Existing use of loop diuretics and ACE inhibitors was associated with a modestly increased risk of lithium toxicity. Initiating loop diuretics or ACE inhibitors sig...

Diuretics have been used as antihypertensive agents since the advent of mercurial diuretics. However, resurrection of thiazides in treatment of hypertension began after the Antihypertensive and Lipid‑Lowering Treatment to Prevent Heart Attack (ALLHAT) trial [1] which brought back diuretics to the forefront in Joint National Committee 7 (JNC 7) recommendations for hypertension. ALLHAT showed tha...

The proposal that thiazide diuretics may increase cardiovascular risk receives no support from recent data. Current evidence does not indicate that diuretic-induced hypokalaemia is associated with increased ventricular arrhythmias. This evidence includes continuous electrocardiographic monitoring--which is the most sensitive technique for quantitating cardiac arrhythmias. In contrast to earlier...

Analysis of the available evidence indicates that diuretics do not increase coronary heart disease morbidity and mortality. The multiclinic trials supporting the cardiotoxicity hypothesis are few in number and flawed in design. The majority of the trials, including the well designed trials, indicate no excess of coronary heart disease (CHD) events in diuretic-treated patients compared with thos...

Our recent Veterans Administration Cooperative Study--involving 683 hypertensive male patients--showed that a diuretic was more effective than a beta blocker in controlling hypertension in most respects. In addition, in this study we failed to find evidence that thiazide-induced hypokalemia was associated with increased evidence of cardiac arrhythmias in patients without overt heart disease. We...