Key result
Among hypertensive patients on multi-drug regimens, 34.9% were not receiving any diuretics, highlighting the underutilization of these agents in clinical practice.
Cross-Sectional (n=25,052)
No
Despite increasing overall diuretic use, thiazide diuretics remain underutilized in multi-drug antihypertensive regimens.
Diuretics remain underused in multidrug regimens; leaves open whether targeted interventions improve evidence-based prescribing.
Recent literature suggests that most hypertensives will require two or more drugs to achieve target blood pressure. Our objective was to estimate the proportion of patients receiving diuretics, including thiazides, for blood pressure control among those receiving two or more drugs. We studied 25,052 hypertensives in a tertiary care Veterans Affairs facility and identified individuals taking any thiazide or loop diuretic among patients receiving two, three, four, or more drugs. Rates of any diuretic use were 50%, 73%, and 89%, and decreased to 39.0%, 59.0%, and 72.5% for thiazide use, respectively. Rates of thiazide use were statistically significantly higher among African Americans compared with the general study population, but did not differ significantly in the elderly. Though overall diuretic use seems to be increasing as compared with previous studies, there is room for improvement in the use of thiazides in multi-drug hypertension regimens.
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Singh et al. (2005) conducted a cross-sectional in Hypertension (n=25,052). Diuretics (including thiazides and loop diuretics) vs. Other antihypertensive regimens was evaluated on Proportion of patients receiving diuretics among those receiving two or more antihypertensive drugs. Among hypertensive patients on multi-drug regimens, 34.9% were not receiving any diuretics, highlighting the underutilization of these agents in clinical practice.
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