Review on Diuretics: Used in the management of Hypertension

Hypertension, a significant global health issue, is particularly prevalent in low- and middle-income countries, such as India, where it affects approximately 25-30% of the population. The rising incidence of hypertension is largely attributed to urbanization, lifestyle changes, and an aging demographic. Among the various antihypertensive treatments, diuretics, especially thiazide diuretics, remain a cornerstone in the management of hypertension due to their proven efficacy, cost-effectiveness, and accessibility. Clinical practice guidelines from organizations like the Indian Society of Hypertension (ISH) consistently recommend thiazide diuretics as firstline therapy for mild to moderate hypertension. Diuretics work by stimulating the kidneys to eliminate excess sodium and water, reducing blood volume and lowering blood pressure. They are particularly valuable for managing primary hypertension and are often used in combination with other antihypertensive agents such as ACE inhibitors, calcium channel blockers, and angiotensin receptor blockers (ARBs) for enhanced therapeutic outcomes, especially in patients with coexisting conditions like diabetes and chronic kidney disease. Diuretics are classified into thiazide, loop, and potassium-sparing types, each with specific indications and mechanisms. Thiazide diuretics are most commonly prescribed for hypertension, while loop diuretics are used for severe fluid retention. This article explores the role of diuretics in hypertension management, emphasizing their clinical significance, benefits, and the strategic approach to treatment in the Indian health.