Diuretics for hypertension and heart failure

In the modern world there is a fairly wide range of diuretic drugs, which are classified and generalized in the category of properties.

By origin, diuretics are divided into the following categories:

  • Diuretics of natural origin (herbs, some foods).
  • Medications – capsules, solutions for internal injection.

And also, depending on their destination, the drugs will be divided into:

  1. Strong diuretics quickly eliminate puffiness, lower blood pressure, and remove toxic substances in severe poisoning.
  2. Diuretics for hypertension for long-term therapy as part of a comprehensive treatment regimen for pathologies of the heart, kidneys, genitourinary tract.
  3. Diuretics that are used to control urination in various diseases.

This classification reflects only two aspects of diuretic drugs, and concerns only their origin and purpose. There are other classifications of drugs that take into account their composition, chemical structure, principle of exposure, adverse reactions, the area of ​​priority therapeutic use.

Classification of funds and “ceiling” diuretics

In medical practice, in order to choose the optimal drug at high pressure, the following classification of drugs is used:

  • Potent drugs that are used once to quickly eliminate swelling, reduce high blood pressure. As a rule, this category of drugs is not used in long-term therapy.
  • Medium-power diuretics are used for long courses, and are part of the complex therapy of hypertension, edematous syndrome against cardiac and renal failure.
  • Potassium-sparing diuretics in their effect are rather weak, but at the same time, they do not contribute to the excretion of potassium ions. They are used in symbiosis with other diuretics, which remove calcium to reduce ion loss.
  • The carbonic anhydrase inhibitor is also a weak diuretic. Helps reduce intracranial as well as ocular pressure.
  • Osmotic drugs are a powerful drug, so they are used in the treatment of acute conditions – cerebral edema, sepsis, lack of urine production.

Strong diuretic drugs are also called loop powerful diuretics (“ceiling” drugs). List of effective drugs:

Strong drugs begin to act after 50 minutes after taking the medicine, the duration of the effect is from 16 to 17 hours. All medications are available in the form of solutions and tablets, so they can be taken orally or intravenously.

The introduction into the vein, as a rule, is carried out only if the patient is in serious condition, and you need to immediately get the desired effect at high pressure. In other situations, medications are recommended in the form of tablets.

The main indication for taking is an edematous syndrome, which is caused by such pathologies:

  • Chronic form of heart failure.
  • Renal failure.
  • Generalized edema and massive proteinuria.
  • The development of swelling due to cirrhosis.

Medications have proven effective in any stage of heart failure, but daily use can cause drug addiction and weaken their healing effect. Therefore, usually drugs are used in small courses, while intervals between doses are carried out.

With hypertension, “ceiling” diuretics are not recommended because they have a powerful, but short-term effect. But, when stopping a hypertensive crisis they are appointed.

General contraindications for taking potent drugs are distinguished:

  1. Lack of urination.
  2. Dehydration with characteristic symptoms.
  3. Lack of sodium.
  4. Individual intolerance to the drug.

To date, doctors most often use Torasemide, ethacrylic acid, Furosemide. Which medicine to choose, only the doctor decides. But, it is permissible to take any of the drugs listed above, because the differences between them are quite insignificant.

Medium Strength Medicines

Medium strength drugs are thiazide diuretics. The list of medicines in this category:

The thiazide group of drugs begins to act after a single dose after 1 hour, the maximum effectiveness occurs after 4-5 hours. It is recommended to apply in such situations:

  1. Compound treatment of arterial hypertension.
  2. Chronic swelling against a background of heart failure.
  3. Diabetes insip >With high blood pressure, drugs are used for long-term therapy, with the exception of periods of exacerbation. As a rule, the dosage of drugs is not large – 25 mg, since such an amount of active substance is sufficient for the occurrence of antihypertensive effects.

Persistent normalization Blood pressure occurs after 2-3 weeks of systematic use, the most pronounced effect is observed in Indapamide. In this regard, in the treatment of hypertension, this drug is indicated by a first-line medication.

Sometimes adverse reactions may occur that depend on changes in the water and electrolyte balance in the human body:

  • Low pressure.
  • Migraine.
  • Lethargy, asthenia.
  • Abdominal cramps.
  • Diarrhea / constipation.
  • Hypersensitivity to bright lighting.

Among all adverse reactions, the most serious is the decrease in the amount of potassium in the blood. In this regard, the thiazide group of drugs is not combined with antiarrhythmic drugs.

Potassium-sparing drugs

Medicines of this category do not contribute to the elimination of potassium from the body, they have a beneficial effect on the work of the heart. In the treatment of hypertension, the following drugs are recommended:

These drugs give a mild and gradual effect, which begins to appear only after 3-4 days from the first use, while the effect lasts for a long time. They are used in the following situations:

  1. Secondary hyperaldosteronism on the background of heart failure, cirrhosis.
  2. In the complex treatment of hypertension.
  3. Diabetes.
  4. Gout.

The main area of ​​use of this group of drugs is their combination with other diuretic drugs to compensate for the lack of a useful substance.

Only these are drugs for eliminating puffiness against the background of heart failure with high blood pressure, they are not used because they have too little effect.

Alternative medicine

Medicinal herbs for the diuretic effect in the treatment of hypertension, as well as in diseases of the heart and blood vessels, in particular, heart failure, should not only remove excess fluid from the body, but also help strengthen the vascular walls, making them more elastic and elastic.

Such an effect can have decoctions based on ordinary mountain ash, chokeberry, grass shepherd’s bag, arnica, barberry inflorescences.

In addition, such medicinal herbs are isolated:

  • Elderberry black, cornflower field.
  • Clove, ordinary bindweed.
  • Valerian, coltsfoot.

Healing herbs have one undoubted advantage – they are completely natural, therefore, effective and harmless to the body. However, in any case, before preparing decoctions and infusions, it is better to consult with your doctor.

Medicinal herbs can not be used in the following cases:

  1. With extreme caution in urolithiasis.
  2. With a deficiency of potassium, almost all herbs are contraindicated.
  3. With prostate adenoma.

It is worth noting that although herbs give the desired effect, you should not get carried away with them either, since with prolonged use, they, along with the liquid, remove useful substances from the body – magnesium, sodium, potassium and others.

In order to avoid negative consequences when treating with herbal preparations, it is better to replenish stocks of nutrients by eating foods that contain a lot of potassium – almonds, figs, and prunes.

In the treatment of hypertension and heart failure, it is better to give preference to teas. The most effective and efficient drinks include:

  • Tea based on birch leaves: pour 100 ml of fresh and chopped leaves into 500 ml of warm water, leave for 10 hours. After filtering, leave until a precipitate appears, filter and drink 10 ml 2 times a day.
  • Tea based on medicinal grass cat mustache must be drunk for 4-6 months with five-day breaks every 30 days.
  • Decoction of flax seeds: pour 5 grams of seeds with 1 liter of hot water, bring to a boil, boil for 15-20 minutes, leave for two hours, then drink 100 ml up to 8 times a day.

It is worth noting that all natural diuretic tinctures / teas are potentially dangerous, because they remove ions from the liquid, as a result, the water-electrolyte balance may be disturbed. And the neglected stages of such a pathology will lead a person to death.

Regardless of the choice of diuretic drugs with high blood pressure, in any case, only a doctor should prescribe them. This also applies to medicinal herbs, because various medicinal herbs have their indications and contraindications.

It is adequately selected plant harvests that can be used for a long period of time, without fear of harmful effects on the body and serious complications. An informative video in this article will talk about diuretics and their role in hypertension.

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Tatyana Jakowenko

Editor-in-chief of the Detonic online magazine, cardiologist Yakovenko-Plahotnaya Tatyana. Author of more than 950 scientific articles, including in foreign medical journals. He has been working as a cardiologist in a clinical hospital for over 12 years. He owns modern methods of diagnosis and treatment of cardiovascular diseases and implements them in his professional activities. For example, it uses methods of resuscitation of the heart, decoding of ECG, functional tests, cyclic ergometry and knows echocardiography very well.

For 10 years, she has been an active participant in numerous medical symposia and workshops for doctors - families, therapists and cardiologists. He has many publications on a healthy lifestyle, diagnosis and treatment of heart and vascular diseases.

He regularly monitors new publications of European and American cardiology journals, writes scientific articles, prepares reports at scientific conferences and participates in European cardiology congresses.

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