Personalizing the Diuretic Treatment of Hypertension: the Need for More Clinical and Research Attention

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• 作者：Samuel J. Mann (1)
  Michael E. Ernst (2) (3)
  
  1. Division of Nephrology and Hypertension ; NY Presbyterian Hospital-Weill Cornell Medical College ; 424 East 70th St ; New York ; NY ; 10021 ; USA
  2. Department of Pharmacy Practice and Science ; College of Pharmacy ; The University of Iowa ; 200 Hawkins Dr ; Iowa City ; IA ; 52242 ; USA
  3. Department of Family Medicine ; Carver College of Medicine ; The University of Iowa ; 200 Hawkins Dr ; Iowa City ; IA ; 52242 ; USA
  
• 关键词：Diuretics ; Hypertension ; Torsemide ; Hydrochlorothiazide ; Spironolactone ; Chlorthalidone
• 刊名：Current Hypertension Reports
• 出版年：2015
• 出版时间：April 2015
• 年：2015
• 卷：17
• 期：4
• 全文大小：234 KB
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• 刊物主题：Internal Medicine; Cardiology; Metabolic Diseases; Nephrology; Primary Care Medicine; General Practice / Family Medicine;
• 出版者：Springer US
• ISSN：1534-3111

文摘

Neither randomized controlled trials nor efforts to identify genetic markers have been helpful with regard to the goal of individualizing diuretic therapy in the treatment of hypertension, a goal that receives little clinical or research attention. This review will examine, and bring attention to, the considerable yet overlooked information relevant to individualizing diuretic therapy. It will bring attention to clinical, biochemical, and pharmacological clues that can be helpful in identifying who is likely to respond to a diuretic, who needs a stronger diuretic regimen, which diuretic to prescribe, and how to minimize adverse effects. New directions for clinical research aimed at individualizing use in hypertension will be explored. Research and clinical attention to the goal of individualizing diuretic treatment in hypertension need to be renewed, to help us achieve greater hypertension control with fewer adverse effects and lower costs.