RT Journal
A1 FREIS ED
T1 CRitique of the clinical importance of diurectic-induced hypokalemia and elevated cholesterol level
JF Archives of Internal Medicine
JO Archives of Internal Medicine
YR 1989
FD December 1
VO 149
IS 12
SP 2640
OP 2648
DO 10.1001/archinte.1989.00390120012004
UL http://dx.doi.org/10.1001/archinte.1989.00390120012004
AB One of the disappointing conclusions of the antihypertensive drug trials is that, while most morbid events were prevented by treatment, the incidence of death from coronary heart disease (CHD) was not significantly reduced. As originally emphasized in the Veterans Administration trial1 and in most subsequent trials, treatment has not resulted in a significant reduction in myocardial infarction (MI) and sudden death.Various hypotheses have been advanced to explain the lack of benefit in the prevention of complications of coronary heart disease, including the following: (1) critical reduction of blood flow in the coronary arteries by lowering blood pressure too far with antihypertensive drugs; (2) initiation of treatment too late in patients with extensive coronary artery atherosclerosis; (3) failure to reduce other risk factors, such as diet and cigarette smoking; (4) inadequate length of follow-up to detect differences; and (5) use of drugs that may increase the risk of CHD