Diuretics in combination antihypertensive therapy: focus on forecast

Abstract

In the modern therapy of arterial hypertension (AH) along with thiazide diuretics b-blockers, calcium antagonists, angiotensin converting enzyme inhibitors and angiotensin receptor blockers are considered for initial and maintenance of antihypertensive therapy in the form of mono - or combination therapy. Five of these classes of drugs have comparable antihypertensive effectiveness and proven impact on prognosis in accordance with the results of randomized controlled clinical trials. The most widely used in clinical practice for the treatment of patients with AH received thiazide diuretics. The most powerful evidence base among the diuretics in regards to the effect on prognosis is chlortalidone. The article presents data from a randomized, placebo-controlled and comparative studies сhlortalidone and hydrochlorothiazide in AH. It is shown that diuretics are the most effective component of combination therapy. The application of a new fixed combination сhlortalidone in combination with azilsartan medoxomil in our country will improve opportunities for effective treatment of this category of patients.

Keywords

• arterial hypertension
• diuretics
• chlortalidone
• hydrochlorothiazide
• azilsartan
• monotherapy
• combination therapy