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- MEDICINE, Page 103Diuretic Dilemma
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- Are water pills risky?
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- When a patient has high blood pressure, the first drug most
- doctors prescribe is a diuretic. By accelerating the loss of
- water and sodium from the body, these medications help lower
- blood pressure and thus decrease the risk of stroke, congestive
- heart failure and kidney failure. But a Swedish study released
- last week provides new evidence that so-called water pills may
- increase the danger of diabetes and heart attacks.
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- Reporting in the New England Journal of Medicine,
- researchers found that when hypertensive patients were given the
- popular diuretic hydrochlorothiazide, their ability to
- metabolize the sugar glucose dropped 11% and their blood levels
- of cholesterol and fats rose 5% and 15%, respectively. The
- researchers stress, however, that there is no proof to date that
- diuretics have raised the actual incidence of diabetes or heart
- attacks.
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- Nonetheless, the new findings have intensified debate about
- whether diuretics should remain a first-line option for
- treating high blood pressure. Many doctors support continued
- widespread use, arguing that newer, alternative drugs are more
- expensive and that their long-term side effects have not been
- as well established. But others are pressing for more restricted
- use of water pills. At the least, say some, patients who have
- diabetes probably should not be taking diuretics.
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