Diuretic Benefits Outweigh Diabetes Risk

Death rate from heart attack or stroke was 15 per cent lower in patients getting a diuretic.

Diuretics, pills used by millions of older people to lower high blood pressure, clearly reduce the long-term risk of death from heart attacks and stroke, according to a study that could ease fears that the medications’ risks outweigh their benefits.

Diuretics, which work by removing fluid from the body, have been used for decades. But doctors have realized in the past few years that the drugs raise the risk of developing diabetes — a condition that can lead to heart attack and stroke.

As a result, some doctors were afraid that diuretics’ risks would cancel out their benefits.

The first long-term study to examine the question found that while diuretics do raise the risk of diabetes, the rate of death from heart attack or stroke was still nearly 15 per cent lower in patients getting a diuretic compared to those who were given dummy pills.

"This is the most conclusive information we’re likely to have, at least for some time,” said Dr. Jeffrey Cutler, senior scientific adviser at the U.S. National Heart, Lung and Blood Institute, a sponsor of the study. "I think this will further reassure physicians.”

National guidelines list diuretics as a first-line treatment for high blood pressure. Nevertheless, some doctors have avoided prescribing diuretics since research linked them to diabetes.

The researchers looked at chlorthalidone, a member of the most common class of diuretics.

Kostis and colleagues at the University of Texas School of Public Health in Houston followed 4,732 patients with high blood pressure for an average of more than 14 years. At the end of that period, 19 per cent of patients given diuretics were dead from cardiovascular causes, compared with 22 per cent of those who got a placebo, or dummy pill.

When the study began, about 17 per cent of patients in each group had diabetes. During the four years that followed, an additional 13 per cent of patients on diuretics and nine per cent on a placebo developed diabetes.

Among patients who developed diabetes, there was a 32 per cent lower risk of cardiovascular death in the diuretics group.
Dr. Valentin Fuster, former American Heart Association president and director of the Cardiovascular Institute at Mount Sinai School of Medicine in New York, said the study answers a critical question for doctors because about one-third of people over age 60 have both high blood pressure and diabetes.

Diuretics, medicine’s oldest blood pressure drug, cost just pennies a day. Some of the newest, most complex blood pressure drugs can cost up to 50 times more.

American Journal of Cardiology, Jan 2005

================================

A pedometer without a program is like a computer without any software.
https://www.rx4betterhealth.com/steptracker/