Diuretics in the treatment of arterial hypertension. What's new?

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Abstract

Data on the antihypertensive efficacy of torasemide loop diuretic, its use as monotherapy and in the combination therapy of arterial hypertension are presented. Data on the mechanisms of antihypertensive action of torasemide are given, including unique antialdosterone action. It is reported that there is no negative effect on carbohydrate, lipid, purine metabolism and electrolyte balance, positive effect on the state of target organs, very good tolerability. The authors conclude that it is possible to use torasemide more widely in a "non-diuretic" dose (2.5-5 mg / day) for the treatment of arterial hypertension both in monotherapy and in combination with other antihypertensive drugs.

About the authors

G. A Baryshnikova

Central State Medical Academy of department of Presidential affairs

Email: bargalan@mail.ru
д-р мед. наук, проф. каф. семейной медицины с курсом клинической лабораторной диагностики ФГБУ ДПО ЦГМА УД Президента РФ 121359, Russian Federation, Moscow, ul. Timoshenko, d. 21

S. A Chorbinskaia

Central State Medical Academy of department of Presidential affairs

д-р мед. наук, проф., зав. каф. семейной медицины с курсом клинической лабораторной диагностики ФГБУ ДПО ЦГМА УД Президента РФ 121359, Russian Federation, Moscow, ul. Timoshenko, d. 21

References

  1. Диагностика и лечение артериальной гипертензии. Российские рекомендации. Четвертый пересмотр // Системные гипертензии. 2010; 3: 5-26
  2. Mancia G, Fagard R et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2013; 31: 1281-357.
  3. Evidence - Based Guideline for the Management of High Blood Pressure in Adults Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC 8). JAMA 2014; 311 (5): 507-20.
  4. Handler J. Maximizing diuretic therapy in resistant hypertension. J Clin Hypertens (Greenwich) 2007; 9 (10): 802-6.
  5. SHEP Cooperative Research Group. Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. Final results of the Systolic Hypertension in the Elderly Program (SHEP). JAMA 1991; 265: 3255-64.
  6. Dahlof B. Sweedish trial in old patients with hypertension (STOP-Hypertension). Clm Exp Hypertens 1993; 15: 925-39.
  7. Major outcomes in high - risk hypertensive patients randomized to angiotensin - converting enzyme inhibitor or calcium channel blocker vs diuretic (The antihypertensive and lipid lowering treatment to prevent heart attack trial - ALLHAT). JAMA 2002; 288: 2981-97.
  8. Wright J.M, Musini V.M. First - line drugs for hypertension. Cohrane Database Syst Rev 2009; 8 (3): CD001841.
  9. Sever P.S, Dahlof B, Poulter N.R et al. For the ASCOT Investigators. Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo - Scandinavian Cardiac Outcomes Trial (ASCOT-BPLA): a multicentre randomized controlled trial. Lancet 2005; 366: 895-906.
  10. Friedel H, Buckley M. Torasemide. A review of its pharmacological properties and therapeutic potential. Drugs 1991; 41 (1): 81-103.
  11. Achhammer I, Metz P. Low dose loop diuretics in essential hypertension. Experience with torasemide. Drugs 1991; 41 (Suppl. 3): 80-91.
  12. Baumgart P, Walger P, von Eiff M, Achhammer I. Long - term efficacy and tolerance of torasemide in hypertension. In: Progress in pharmacology and Clinical Pharmacology. Gustav - Fischer - Verlag: Stuttgart 1990; 8: 169-81.
  13. Baumgart P. Torasemide in comparison with thiazides in the treatment of hypertension. Cardiovasc Drugs Ther 1993; 7 (Suppl. 1): 63-8.
  14. Spannbrucker N, Achhammer I, Metz P, Glocke M. Comparative study on the hypertensive efficacy of torasemide and indapamide in patients with essential hypertension. Drug Res 1988; 38 (1): 190-3.
  15. Reyes A.J, Chiesa P.D, Santucci M.R et al. Hydrochlorothiazide versus a nondiuretic dose of torasemide as once daily antihypertensive monopharmacotherapy in elderly patients; randomized and double - blind study. In: Progress in Pharmacology and Clinical Pharmacology. Gustav - Fischer - Verlag: Stuttgart 1990; 8: 183-209.
  16. Achhammer I, Eberhard R. Comparison of serum potassium levels during long - term treatment of hypertension patients with 2.5 mg torasemide o.d. or 50 mg triamterene/25 mg hydrochlorothiazide o.d. In: Progress in Pharmacology and Clinical Pharmacology. Gustav - Fischer - Verlag: Stuttgart 1990; 8: 211-20.
  17. Spannbrucker N, Achhammer I, Metz P, Glocke M. Comparative study on the hypertensive efficacy of torasemide and indapamide in patients with essential hypertension. Drug Res 1988; 38 (1): 190-3.
  18. Knauf H, Mutschler E, Velazquez H et al. Torasemide significantly reduces thiazide - induced porassium and magnesium loss despite supraadditive natriuresis. Eur J Clin Pharmacol 2009; 65: 465-72.
  19. Liguori A, Casini A, Di Loreto M et al. Loop diuretics enhance the secretion of prostacyclin in vitro, in healthy persons, and in patients with chronic heart failure. Eur J Clin Pharmacol 1999; 55: 117-24.
  20. Spieker C, Zidek W, Häcker W et al. Assessment of intracellular sodium and calcium in essential hypertension during diuretic treatment. Arzneimittelforschung 1988; 38: 1188-90.
  21. Goodfriend T.L, Ball D.L, Oelkers W, Bähr V. Torsemide inhibits aldosterone secretion in vitro. Life Sci 1998; 63 (3): 45-50.
  22. Franse L.V, Pahor M, Di Bari M et al. Hypokalemia associated with diuretic use and cardiovascular events in the Systolic Hypertension in the Elderly Program. Hypertension 2000; 35: 1025-30.
  23. Harada K, Izawa H, Nishizawa T et al. Beneficial effects of torasemide on systolic wall stress and sympathetic nervous activity in asymptomatic or mildly symptomatic patients with heart failure: comparison with azosemide. J Cardiovasc Pharmacol 2009; 53 (6): 468-73.
  24. Rossi G.P, Bernini G, Caliumi C et al. A prospective study of the prevalence of primary aldosteronism in 1,125 hypertensive patients. J Am Coll Cardiol 2006; 48 (11): 2293-300.
  25. Mosso L, Carvajal C, Gonzalez A et al. Primary aldosteronism and hypertensive disease. Hypertension 2003; 42: 161-5.
  26. Schunkert H, Hense H.W, Muscholl M et al. Associations between circulating components of the renin - angiotensin - aldosterone system and left ventricular mass. Heart 1997; 77: 24-31.
  27. Аверин Е.Е. Влияние торасемида на гипертрофию миокарда левого желудочка. Сердечная недостаточность. 2012; 13 (3): 158-61.
  28. Lopez B, Querejeta R, Gonzales A et al. Effects of loop diuretics on myocardial fibrosis and collage type I turnover in chronic heart failure. J Am Coll Cardiol 2004; 43 (11): 2028-35.
  29. Massare J, Berry J.M, Luo X et al. Diminished cardiac fibrosis in heart failure is associated with altered ventricular arrhythmia phenotype. J Cardiovasc Electrophysiol 2010; 21 (9): 1031-7.
  30. Lopez B, Querejeta R, Gonzales A et al. Effects of loop diuretics on myocardial fibrosis and collage type I turnover in chronic heart failure. J Am Coll Cardiol 2004; 43 (11): 2028-35.
  31. Ткачева О.Н., Шарашкина Н.В., Новикова И.М. и др. Применение петлевого диуретика торасемида в комбинированном лечении гипертонической болезни у женщин в период постменопаузы // Consilium Medicum. 2011; 13 (10): 54-9.
  32. Brown N.J. Aldosterone and end - organ damage. Curr Opin Nephrol Hypertens 2005; 14 (3): 235-41.
  33. Born-Frontsberg E, Reincke M, Rump LC et al. Cardiovascular and cerebrovascular comorbidities of hypokalemic and normokalemic primary aldosteronism: results of the German Conn/'s Registry. J Clin Endocrinol Metab 2009; 94 (4): 1125-30.
  34. Свиряев Ю.В., Звартау Н.Э., Коростовцева Л.С. и др. Сравнительная оценка эффективности и безопасности Тригрима и Арифона Ретард у больных с арТериальной гипертонией в слепом рандомизированном исследовании в параллельных группах (исследование СТАРТ). Сердце. 2014; 13 (6): 389-95.

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