Why the study?
What are the hemodynamic mechanisms underlying the antihypertensive effects of diuretic therapy in hypertension?
What are the hemodynamic mechanisms underlying the antihypertensive effects of diuretic therapy in hypertension?
The antihypertensive effect of diuretics is primarily mediated by a reduction in total peripheral vascular resistance rather than fluid volume reduction, though it does not reverse structural vascular changes.
Informs mechanism-based diuretic selection; leaves open reversal of structural vascular changes with long-term therapy.
The antihypertensive effect of diuretics is well documented. At least some preserved kidney function seems to be necessary to achieve a demonstrable effect. The importance of fluid volume reduction for the antihypertensive effect of these drugs during long-term treatment is however uncertain. The effects on central hemodynamics vary according to the literature, but the blood pressure reduction in responders (delta MAP greater than 10%) may primarily be explained by a reduction of the total peripheral vascular resistance. The peripheral circulation is influenced in the same way. Sometimes a flow reduction is observed, and sometimes a resistance reduction. In spite of a lasting blood pressure reduction after treatment with diuretics, the structural hypertensive vascular changes do not seem to be influenced.
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Mats Danielson (1984) studied this question.
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