| Arch Intern Med 2003;163:2557-60 |
|
| Do thiazide diuretics confer specific protection against strokes? |
|
| Messerli FH, Grossman E, Lever AF |
|
| Section on Hypertensive Diseases, Ochsner Clinic , LA 70121, USA
and Hypertension Unit the Chaim Sheba Medical Center, Tel-Hashomer
Israel |
|
| Several large studies have suggested that therapy with thiazide diuretics
confers a particular benefit in reducing the risk of strokes that seem
to be, at least to some extent, independent of the blood pressure-lowering
effect. Such a cerebroprotective effect was documented not only with
monotherapy but also when diuretics were used in combination with other
drugs. The cerebroprotective effect does not seem to be shared by other
drug classes, such as the beta-blockers or the angiotensin-converting
enzyme inhibitors, in patients without manifest cardiovascular disease.
Since stroke is one of the most devastating sequelae of high blood
pressure, our data strongly favor the use of low-dose diuretics either
as initial therapy or in combination in all hypertensive patients at
risk for cerebrovascular disease. |
