Thiazide may pose some risk for congestive heart failure patients

http://www.eurekalert.org/pub_releases/2015-11/uoca-tmp110415.php

Public Release: 6-Nov-2015
Thiazide may pose some risk for congestive heart failure patients
University of Cincinnati Academic Health Center

Thiazide, a popular diuretic for lowering high blood pressure, may not excrete salt as expected in patients with congestive heart failure and or dehydration and should be taken with caution, say researchers at the University of Cincinnati.

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"Several recent studies have shown that in humans, the anti-hypertensive effects of thiazides are enhanced if those subjects are on a salt-restricted diet. Our studies demonstrate that salt restriction shifts the anti-hypertensive mechanism of thiazides from diuresis (salt excretion) to a vasorelaxation (relaxing the arteries)," says Soleimani.

"One group of patients taking thiazides are patients with fluid overload due to congestive heart failure who are prone to volume depletion (dehydration) due to a number of factors," he explains. "Our studies suggest that those patients should be very cautious with taking thiazide since it can drop the blood pressure and reduce blood flow to the kidney and the brain and cause dizziness without increasing salt excretion."

Soleimani says volume depletion in patients with congestive heart failure should be corrected before physicians prescribe a thiazide derivate. Otherwise, physicians should consider switching the patient to another medication, he explains.

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