Diuretics for Hypertension: A Review and Update https://doi.org/10.1093/ajh/hpw030 Published: 05 April 2016 Article history PDF Cite Permissions amiloride angiotensin-converting enzyme inhibitors antihypertensive agents potassium proteinuria enalapril amlodipine chlorthalidone indapamide spironolactone beta-blockers calcium channel blockers diuretics hypertension premature ventricular contractions hypertension, refractory aldosterone antagonists thiazide diuretics endothelium signs and symptoms systole guidelines loop diuretics thiazide hydrochlorothiazide eplerenone cardiovascular event Subject Therapeutics Issue Section: Review With the advent of chlorthiazide in 1958, thiazide diuretics quickly became a key component in the management of hypertension. View largeDownload slide Trends in antihypertensive drug prescriptions in US adults from Kantor et al . Salt-sensitive hypertension is present when, following sodium loading, its deprivation and removal lead to a drop in systolic blood pressure (SBP) of 10mm Hg or more. Possible methods for recognizing salt-sensitive hypertension in routine clinical practice include use of genetic markers, 4 BP response to amiloride analogues, 5 and measures obtained from 24-hour ambulatory monitoring, 6 but none of these methods has achieved wide acceptance and general use. Thus, clinicians rely on studies demonstrating that there is a higher prevalence of salt-sensitive hypertension in Blacks, the obese, the elderly, and some diabetics. 7 Although diuretics may be particularly valuable in such patients, it should be remembered that, irrespective of salt-sensitive status, large meta-analyses have shown that low-dose diuretics compared to other antihypertensives have demonstrated superiority and have the most evidence available. 8 , 9 Thus, most recent guidelines continue to recommend thiazide-related diuretics as first-line agents for all patients with hypertension ( Table 1 ). Here, we summarize their essential features ( Tables 2 and 3 ), review their impact on CVEs ( Table 4 ), and report on recent clinical studies.
CORRECTED PROOF The Risk of Hypertension Doubles Every 10 Years in China: Age, Period, and Birth Cohort Effects on the Prevalence of Hypertension From 2004 to 2013 https://doi.org/10.1093/ajh/hpz003 Published: 19 January 2019 Article history Cite Permissions hypertension china cohort effect Subject Epidemiology Issue Section: Original Article © American Journal of Hypertension, Ltd 2019. All rights reserved. For Permissions, please email: [email protected] This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/p...er_policies/chorus/standard_publication_model)
Perspective > theheart.org on Medscape > Heartfelt with Dr Melissa Walton-Shirley > ACC 2019 COMMENTARY What's New and Useful in Hypertension From ACC.19 Melissa Walton-Shirley, MD INFINITY trial[told me that even when cohorts are supervised, educated, and adherent, they can't accurately check their own random pressures at home. But one additional lesson from the INFINITY trial was lost in the bright light cast by the trial design. Cardiologists largely ignore the incidental finding of abnormal white matter intensity on brain CT and MRI, much like noncardiologists often ignore coronary calcium on CT scans. Both findings are accepted as common effects of aging instead of being seen as red flags. We should make a pact: Cardiologists will step up our surveillance on hypertension control when we see white matter abnormalities. Noncardiologists will quantitate coronary calcium and refer for risk stratification when appropriate. There. I think we can all shake on that. Lesson 3: Acknowledging white matter hyperintensity "as a thing" was the unspoken take-home from the INFINITY trial. The CREOLE Trial Sub-Saharan Africa is writhe with poorly controlled hypertension and affords a unique opportunity to study cohorts often underrepresented in major trials. CREOLE[2] compared three treatment groups: Amlodipine + hydrochlorothiazide (HCTZ) Amlodipine + perindopril Perindopril + HCTZ
