Diuretics in treatment of patients with arterial hypertension

Since all cardiovascular risk factors contribute to coronary artery disease in patients with arterial hypertension, they should all be considered in the managementof this disease process. Thiazides diuretics when used at high doses, negatively impact lipid and glucose metabolism. These findings have resulted indecreased use of diuretics in favor of newer agents such as ACE inhibitors and calcium antagonists. However, recent data have demonstrated that whenused at low doses (6.25 or 25 mg of hydrochlorothiazide), diuretics lack significant metabolic side effects while bringing about significant reductions in bloodpressure. Thus, at these doses, hydrochlorothiazide is a useful drug in the treatment of hypertension, both as monotherapy and in combination therapy.