It is known that hypertension (arterial hypertension, or hypertension) is characterized by resistance to high blood pressure in which the heart is forced to work intensively. Load leads to a weakening of the heart muscle, and the insufficiency of pumping function of the organ leads to a delay in removing sodium and fluid via the kidneys. This is manifested by stagnation of excess water in the body, edema of limbs. In such cases, the physician writes the patient diuretics. Diuretics for hypertension and heart failure are used for the combined treatment. About this later in the article.
How diuretics work
In hypertension excess sodium causes contraction of smooth muscles of the vascular walls. From the effects of diuretics in hypertension and heart failure blood vessels dilate, slows down the flow of sodium ions from the renal tubules into the blood. Relaxes smooth muscles bronchi, biliary tract. The result of this spasmolytic effect of diuretics normalization of blood pressure, getting rid of excess fluid. Diuretics are complementary drugs for the treatment of hypertension.
Treatment of arterial hypertension
The action of diuretics in hypertension and heart failure are distinguished by the degree of influence on the structural and functional unit of kidneys (nephron). This takes into account the duration of therapeutic effects, the ability to relieve swelling, to reduce high blood pressure. Depending on variables such diuretics are classified according to pharmacological groups:
Potent (loopback drugs):
- The effects of these medicines are felt after only an hour after ingestion, lasts for 16-18 hours. Strong diuretics can effectively inhibit the process of applying to the blood of ions of chlorine, sodium, but increase the leaching of potassium (bad for heart). Loop drugs are used in hypertensive crises as a quick-acting medications, are appointed for a short period, is considered acceptable for patients with different degrees of renal insufficiency.
The average strength diuretics (thiazides):
- Thiazide drugs are prescribed in small doses for long-term treatment of hypertension in non-acute phase. They reduce blood volume, dilate blood vessels, thinning their walls, reduce the amount of uric acid from the body. To achieve sustainable normalize blood pressure with the thiazide takes 2-4 weeks.
Drugs with a reduced antihypertensive effect (potassium-sparing):
- Diuretics in this class are divided into hormonal and non-hormonal, reach therapeutic effect on the second or third day. Stimulating the secretion of sodium ions, potassium-sparing diuretics reduce the Exodus of potassium from the body, targeted to remote from the center line of the body (distal) tubules of the kidneys.
In modern medicine, diuretics are often used for maintaining a specific state of the patient, often assigned to older people. The value of diuretics is considered to be available to many people. In hypertension potassium-sparing drugs are combined with thiazide and loop. Diuretics in heart failure similar drugs for patients with hypertension.
- «Indapamide» is rapidly being absorbed, acts 10-12 hours. The medicine stops the contractions of the vascular walls, lowers blood pressure, large volume urination causes. Adopted the morning 1 tablet of the diuretic is enough for the day, with increased doses of the diuretic effect increases.
- «Gidrohlortiazid (Dihlotiazid», «Hydrochlorothiazide», «Netrix») pressure decreases slightly, but reduces the leaching of calcium, is indicated for osteoporosis. The drug is well absorbed, and after about an hour reaches the maximum concentration. After meals 1-2 tablets washed down with water 1 times per day.
- «Cyclomethiazide», («Navidrex») is recommended not only in hypertensive the swelling, but in cases of kidney disease, of glaucoma. Is also well absorbed, effectively accelerates the urine, keeping a diuretic effect to half a day. This diuretic take in the morning on 0.5 mg a day.
- «Britomart» (similar to «Diver») – the basis of the drug is a substance torasemid concentrated in the blood after 1.5 hours. Suspending the flow of blood to the sodium and chlorine ions in the tubular loop of the nephron, reduces the pressure in the low mobility state. The diuretic is accepted without reference to the food regime of 20 mg per day.
- «Lasix» is absorbed by 64% regardless of the dose, suppresses the flow in the blood sodium and chlorine ions in the tubular loop of the nephron, reduces swelling, stimulates but the outcome of potassium, calcium and magnesium from the body. The drug take 40 mg 2 times per day.
- «Furosemide» refers to fast-acting diuretics, it is recommended for patients with severe forms of hypertension (e.g. renal failure). Within 3 hours the drug increases the excretion of sodium and chloride, increase peripheral vessels, reduces blood pressure. Medicine take morning 40 mg, if required the second method, wait 6 hours.
- «Verospiron» refers to the group of hormonal drugs is well absorbed and prevents the influence of the hormone aldosterone stimulates the excretion of sodium and water, reduces the leaching of potassium, reduces the acidity of urine. The drug is taken on 15 days at 100 mg per day.
- «Amiloride» non-hormonal diuretic. The drug stimulates the excretion of sodium ions, chlorine, inhibits the leaching of potassium. The impact is calculated on the distal tubules of the kidneys. Medication take 20 mg per day.
Folk diuretics for hypertension
Fees herbs, stimulating urination, diuretics differ from mild curative effect, no side effects. Herbal decoctions and infusions according to popular recipes require the use of a systematic, long-term. Diuretics of this kind can be used for complex or supportive treatment that does not eliminate loss of magnesium and potassium. For this reason, you need to regularly eat rice, oatmeal, raisins, rosehips, dried apricots (or fresh apricots), bananas.
Infusion-based drug collection:
- Equal parts of bearberry, Hypericum, nettle, rosehips, plantain carefully grind and mix.
- Scooping up 1 tbsp. l. collection, be placed in a convenient bowl, pour 0.5 liters of boiling water, to insist 1 hour, drain.
- Drink small portions, stretching for 3 days.
Honey with a decoction of burdock root:
- Cut the root parts of the plant.
- Measure out 3 tbsp of raw materials in a pan and add 1 liter of boiling water.
- Simmer on low heat until it evaporates from broth 0.5 liters of water, sweeten with honey to taste (can sugar).
- To drink 0.5 cups three times a day.
How to use a group of drugs for the treatment of hypertension
Diuretics in hypertension are prescribed in the minimum dosage. If swelling does not subside, the doctor increases the patient dose. The expediency of application of different groups of diuretics is strongly influenced by a high probability of side effects and syndrome addiction. Prolonged use of diuretics, excess doses there is a probability of appearance of diabetes mellitus, disorders of ion balance.
- Thiazides promote the concentration of uric acid, increase the rate of cholesterol, blood sugar, patients with diabetes insipidus the urine lower.
- Loop diuretics can cause a potassium deficiency (hypokalemia), arrhythmia, muscle weakness, spasms.
- Hormonal diuretics provoke diarrhoea, vomiting, headache, convulsions, rash, disorders of libido.
- General side effects for all groups of diuretics are considered to be drowsiness, fatigue, insomnia, dry mouth and feeling thirsty, weakness, nausea, pain in the kidneys.
- decompensated cirrhosis of the liver;
- acute renal and respiratory failure.
Resistance to diuretics
If the body does not respond to diuretics, excess fluid is not excreted. This condition occurs in long-term use of diuretics, which is typical for patients with severe forms of heart failure. A list of common reasons for resistance to diuretics include hormonal disorders, disorders of the digestive tract and vascular system. In this situation it is recommended to restrict fluid intake.
Video: why you need diuretics at high pressure