Abstract
Diuretics have appropriately maintained a stable place in the management of hypertension and heart failure (HF) because of their proven efficacy and low cost. The aldosterone antagonists spironolactone and its analog eplerenone are diuretics but have added actions that improve myocardial function and are an important part of our armamentarium for the management of patients with HF.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsPreview
Unable to display preview. Download preview PDF.
References
Maclean D, Tudhope GR. Modern diuretic treatment. BMJ 1983;286:1419.
Kerry RJ, Ludlow JM, Owen G. Diuretics are dangerous with lithium. BMJ 1980;281:371.
Yeung Laiwah AC, Mactier RA. Antagonistic effect of non-steroidal anti-inflammatory drugs on frusemide-induced diuresis in cardiac failure. BMJ 1981;283:714.
Puschett JB. Renal effects of bumetanide. J Clin Pharmacol 1981;21:575.
Sherman LG, Liang C, Baumgardner S, et al. Piretanide, a potent diuretic with potassium-sparing properties, for the treatment of congestive heart failure. Clin Pharmacol Ther 1986;40:587.
Narins RG (ed). Maxwell & Kleeman’ s Clinical Disorders of Fluid and Electrolyte Metabolism, 5th ed. New York, McGraw-Hill, 1994.
Siscovick DS, Raghunathan TE, Psaty BM. Diuretic therapy for hypertension and the risk of primary cardiac arrest. N Engl J Med 1994;330:1852.
Webert KT. Aldosterone in congestive heart failure. N Engl J Med 2001;345:1689.
Favre L, Glasson P, Vallotton MB. Reversible acute renal failure from combined triamterene and indomethacin: A study in healthy subjects. Ann Intern Med 1982;96:317.
Weinberg MS, Quigg RJ, Salant DJ, et al. Anuric renal failure precipitated by indomethacin and triamterene. Nephron 1985;40:216.
Ettinger B, Oldroyd NO, Sorgel F. Triamterene nephrolithiasis. JAMA 1980;244:2443.
Weber KT. Aldosterone and spironolactone in heart failure. N Engl J Med 1999;341:753.
Farquharson CAJ, Struthers AD. Spironolactone increases nitric oxide bioactivity, improves endothelial vasodilator dysfunction, and suppresses vascular angiotensin I/angiotensin II conversion in patients with chronic heart failure. Circulation 2000;101:594.
RALES: Pitt B, Zannad F, Remme WJ, et al. for the Randomized Aldactone Evaluation Study investigators. The effect of spironolactone on morbidity in patients with severe heart failure. N Engl J Med 1999;341:709.
Khan M Gabriel. Treatment of refractory congestive heart failure and normokalemic hypochloremic alkalosis with acetazolamide and spironolactone. Can Med Assoc J 1980;123:883.
Whelton A. An overview of national patterns and preferences in diuretic selection. Am J Cardiol 1986; 57:2A.
Hohnloser SH, Verrier RL, Lown B, et al. Effect of hypokalemia on susceptibility to ventricular fibrillation in the human and ischemic canine heart. Am Heart J 1986;112:32.
Clausen T. Adrenergic control of Na+-K+-homoeostasis. Acta Med Scand 1983;Suppl 672:111.
Farquharson-Roberts MA, Giddings AEB, Nunn AJ. Perforation of small bowel due to slow release potassium chloride (Slow-K). BMJ 1975;3:206.
Mahon FG, Ryan JR, Akdamar K, et al. Upper gastrointestinal lesions after potassium chloride supplements: A controlled clinical trial. Lancet 1982;2:1059.
Rodriguez JA, Godoy I, Castro P, et al. Ramipril vs. espironolactona en el remodelamiento ventricular izquierdo post-infarto: randomizado y dobleciego. Rev Med Chile 1997;125:643–652.
EPHESUS: Pitt B, Remme W, Zannad F, et al. for the Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study Investigators. Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction. N Engl J Med 2003;348:1309–1321.
de Gasparo M, Joss U, Ramjoue HP, et al. Three new epoxy-spirolactone derivatives: Characterization in vivo and in vitro. J Pharmacol Exp Ther 1987;240:650–656.
Rocha R, Rudolph AE, Frierdich GE, et al. Aldosterone induces a vascular inflammatory phenotype in the rat heart. Am J Physiol Heart Circ Physiol 2002;283:H1802–H1810.
Sun Y, Zhang J, Lu L, Chen SS, Quinn MT, Weber KT. Aldosterone-induced inflammation in the rat heart: role of oxidative stress. Am J Pathol 2002;161:1773–1781.
Struthers AD, MacDonald TM. Review of aldosterone-and angiotensin II-induced target organ damage and prevention. Cardiovasc Res 2004;61:663–670.
Rajagopalan S, Duquaine D, King S, Pitt B, Patel P. Mineralocorticoid receptor antagonism in experimental atherosclerosis. Circulation 2002;105:2212–2216.
Suzuki G, Morita H, Mishima T, et al. Effects of long-term monotherapy with eplerenone, a novel aldosterone blocker, on progression of left ventricular dysfunction and remodeling in dogs with heart failure. Circulation 2002; 106:2967–2972.
Zhang ZH, Francis J, Weiss RM, Felder RB. The renin-angiotensin-aldosterone system excites hypothal — amic paraventricular nucleus neurons in heart failure. Am J Physiol Heart Circ Physiol 2002;283:H423–H433.
Barr CS, Lang CC, Hanson J, Arnott M, Kennedy N, Struthers AD. Effects of adding spironolactone to an angiotensin-converting enzyme inhibitor in chronic congestive heart failure secondary to coronary artery disease. Am J Cardiol 1995;76:1259–1265.
Korkmaz ME, Muderrisoglu H, Ulucam M, Ozin B. Effects of spironolactone on heart rate variability and left ventricular systolic function in severe ischemic heart failure. Am J Cardiol 2000;86:649–653.
Francis GS, Tang WHW. Should we consider aldosterone as the primary screening target for preventing cardiovascular events? J Am Coll Cardiol 2005;45:1249–1250.
Struthers AD, MacDonald TM. Review of aldosterone-and angiotensin II-induced target organ damage and prevention. Cardiovasc Res 2004;61:663–670.
Mottram PM, Haluska B, Leano R, Cowley D, Stowasser M, Marwick TH. Effect of aldosterone antagonism on myocardial dysfunction in hypertensive patients with diastolic heart failure. Circulation 2004; 110:558–565.
Macdonald JE, Kennedy N, Struthers AD. Effects of spironolactone on endothelial function, vascular angiotensin converting enzyme activity, and other prognostic markers in patients with mild heart failure already taking optimal treatment. Heart 2004;90:765–770.
Suggested Reading
Bauersachs J, Heck M, Fraccarollo D, et al. Addition of spironolactone to angiotensin-converting enzyme inhibition in heart failure improves endothelial vasomotor dysfunction: Role of vascular superoxide anion formation and endothelial nitric oxide synthase expression. J Am Coll Cardiol 2002;39:351–358.
Beygui F, Collet J-P, Benoliel J-J, et al. High plasma aldosterone levels on admission are associated with death in patients presenting with acute ST-elevation myocardial infarction. Circulation 2006; 114:2604–2610.
Calhoun DA. Aldosterone and cardiovascular disease: smoke and fire. Circulation 2006; 114:2572–2574.
Francis GS, Tang WHW. Should we consider aldosterone as the primary screening target for preventing cardiovascular events? J Am Coll Cardiol 2005;45:1249–1250.
Jaffe IZ, Mendelsohn ME. Angiotensin II and aldosterone regulate gene transcription via functional mineralocortocoid receptors in human coronary artery smooth muscle cells. Circ Res 2005;96:643–650.
Macdonald JE, Kennedy N, Struthers AD. Effects of spironolactone on endothelial function, vascular angiotensin converting enzyme activity, and other prognostic markers in patients with mild heart failure already taking optimal treatment. Heart 2004;90:765–770.
Mottram PM, Haluska B, Leano R, Cowley D, Stowasser M, Marwick TH. Effect of aldosterone antagonism on myocardial dysfunction in hypertensive patients with diastolic heart failure. Circulation 2004; 110: 558–565.
Pitt GS, Pitt B. Aldosterone, ion channels, and sudden death: another piece of the circle? Am J Physiol 2006; 290:H2176–H2177.
Rights and permissions
Copyright information
© 2007 Humana Press Inc., Totowa, NJ
About this chapter
Cite this chapter
(2007). Diuretics. In: Cardiac Drug Therapy. Contemporary Cardiology. Humana Press. https://doi.org/10.1007/978-1-59745-238-0_7
Download citation
DOI: https://doi.org/10.1007/978-1-59745-238-0_7
Publisher Name: Humana Press
Print ISBN: 978-1-58829-904-8
Online ISBN: 978-1-59745-238-0
eBook Packages: MedicineMedicine (R0)