Diuretics in hypertension: treatment, how to choose
Many people today suffer from hypertension, i.e. high blood pressure. Diuretics in arterial hypertension (AH) is one of the most popular methods of treatment of the condition. These drugs can in time and with the fewest negative effects to stop the disease that doctors often called the «invisible killer». The following are the most popular diuretics and their mechanism of action.
What are diuretics?
Diuretic — a drug prescribed for high blood pressure, which develops due to fluid retention in the body because of slow excretion of substances such as sodium, potassium, chlorine. While taking a diuretic, the output level of sodium rises, and the substance begins to appear better, the swelling subsides, and the pressure drops. Diuretics for treatment of hypertension are divided into groups according to their effect on the body.
How to choose a diuretic in the treatment of hypertension?
At high pressure
If the patient needs to quickly lower blood pressure, prescribe a drug from the group of loop diuretics. Among them — «Ethacrynic acid», «Clopamide» and «Hydrochlorothiazide». The last drug begins to act already in the first hours after ingestion and continues to work 12-18 hours. Besides «Hydrochlorothiazide» it is well absorbed by the gastrointestinal tract and thus has no negative impact on the acid-alkaline balance. This drug is administered at 25-100 mg once or twice a day.
«Ethacrynic acid» works even faster — within 30-60 minutes after taking, but it continues this action is 6-9 hours. This good diuretic that does not violate the electrolyte composition of the blood. The drug can be combined with other diuretics. With increased acidity of the blood using the drug «Furosemide». On a chemical level it works just like other diuretics. The effect of taking comes quickly — in 20-30 minutes, but the action of the drug is not very long — a little over 4 hours.
Diuretics from the group loop is not desirable to take a long time, as they are very actively wash the body of magnesium and calcium.
At low levels of potassium in the blood
The next group — potassium-sparing diuretics. These drugs inhibit the output of potassium from the body. Usually funds of this group are used together with other diuretics to prevent leaching of too much potassium. By themselves, potassium-sparing diuretic not very effective for gipertenzii as a little lower blood pressure. This group includes «Spironolactone», «Amiloride» and «Triamterene».
«Spironolactone,» you can find under other names — «Verospiron» and «Aldactone». This tool displays the body of water with sodium, delaying potassium. «Spironolactone» is rapidly absorbed in the gastrointestinal tract, especially this process is accelerated by concomitant food intake. The drug begins to operate normally in 2-5 days after ingestion. «Triamterene» is almost the same. But the drug «Amiloride» stands out, which begins to work 2 hours after taking it.
The last group is called the thiazide diuretics. They also reduce the excretion of potassium from the body and are assigned to patients who, in addition to gipertenzii, suffer from osteoporosis. Thiazide drugs lower blood pressure and, due to the blocking of potassium in the body, reduce bone fragility. Usually administered together with potassium-sparing diuretics. Among the drugs ― «Indapamide», «Chlorothiazide», «Chlorthalidone», «Bendroflumethiazide», «Hydroflumethiazide», «Hydrochlorthiazide».
Most popular «Indapamide». It increases the volume of urine output, thus reducing venous return to the heart, to reduce the load on it and, consequently, lower the pressure. The drug is not advised to use during pregnancy and children up to 18 years. More often prescribe «Chlorthalidone». Like other diuretics, the drug blocks the absorption of sodium and chlorine ions, delay in the body of calcium and thus reduces cardiac output. For the preparation of typical long-term effect of up to 72 hours after ingestion. Administered 50-200 mg 1 times per day.
Negative effects from taking
Naturally, diuretics have their own side effects, especially with prolonged use:
- The disturbance of the water balance due to the large volume of urine output. Reception of thiazide and loop diuretics can affect the reduction of circulating blood volume due to reducing the amount of sodium. This process is accompanied by tachycardia, dryness of the mouth. To reduce the negative effects of drugs, you need to increase the intake of water and salt.
- Hypokalemia — low potassium in the blood. To avoid it, it is advisable to take together with drugs and even potassium-sparing diuretics, and foods containing potassium (greens, tomatoes, potatoes, bananas, nuts, and beans). But you have to be careful, because an overabundance of potassium also has a negative impact on the body.
- The decrease in blood levels of phosphates. This can be pain in the bones. To prevent this symptom, we recommend the use of products containing phosphates (such as meat, dairy products, eggs, legumes).
- A violation of carbohydrate metabolism, so drugs it is not advisable to take people with diabetes.
In order to reduce the negative effects from taking diuretics, you need to adhere to the so-called gipoholesterinovu diet. It is to reduce consumption of fatty meat, fried foods, starchy foods. It is advisable to abandon products that are exciting to the nervous system, for example, from coffee and tea, from bad habits such as Smoking and regularly checking blood pressure.