Di praktik, diuretik thiazide sering digunakan pada pasien hipertensi, namun terkadang dokter tidak memahami rasionalitas penggunaan obat golongan ini. Diuretik thiazide, misalnya hydrochlorothiazide (HCT), adalah obat antihipertensi pertama yang ditemukan tahun 1957, yang terbukti efektif menurunkan tekanan darah serta mortalitas dan morbiditas kardiovaskular. [1] Dalam guideline hipertensi dari Joint National Committee (JNC) 8 tahun 2014 maupun American College of Cardiology/American Heart Association (ACC/AHA) tahun 2017, diuretik thiazide dimasukkan sebagai obat antihipertensi lini pertama.[2,3]
Perbandingan Efektivitas Golongan Antihipertensi
Berbagai studi telah mencoba membandingkan efektivitas berbagai golongan obat antihipertensi. Beberapa di antaranya adalah publikasi oleh Fretheim et al tahun 2012, Xue et al tahun 2015, dan Yang et al tahun 2016.[4,5,6].
(Konten ini khusus untuk dokter. Registrasi untuk baca selengkapnya)
Referensi
1. Salvetti A, Ghiadoni L. Thiazide diuretics in the treatment of hypertension. Am Soc Nephrology. 2006;17:S25-29. https://jasn.asnjournals.org/content/17/4_suppl_2/S25
2. JNC 8 hypertension guideline algorithm. http://www.nmhs.net/documents/27JNC8HTNGuidelinesBookBooklet.pdf
3. Cifu AS, Davis AM. Prevention, detection, evaluation, and management of high blood pressure in adults. JAMA Clin Guid Syn. 2017; 318(21): 2132-4. https://jamanetwork.com/journals/jama/article-abstract/2664350
4. Fretheim A, Odgaard-Jensen J, Brors O, Madsen S, Njostad I, Norheim OF, et al. Comparative effectiveness of antihypertensive medication for primary prevention of cardiovascular disease: systematic review and multiple treatments meta-analysis. BMC Medicine. 2012; 10: 33. https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-10-33
5. Xue H, Lu Z, Tang WL, Pang LW, Wang GM, Wong GW, et al. First-line drugs inhibiting the renin angiotensin system versus other first-line antihypertensive drug classes for hypertension. Cochrane. 2015; 1: CD008170. https://www.ncbi.nlm.nih.gov/pubmed/25577154
6. Yang Y, Huilan X. Comparing six antihypertensive medication classes for preventing new-onset diabetes mellitus among hypertensive patinets: a network meta-analysis. J Cell Mol Med. 2017; 21(9): 1742-50. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5571556/
7. Musini VM, Nazer M, Bassett K, Wright JM. Blood pressure-lowering efficacy of monotherapy with thiazide diuretics for primary hypertension. Cochrane. 2014;1. DOI: 10.1002/14651858.CD008170.pub2.
8. ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial: Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA. 2002; 288: 2981-97.
9. Davis BR, Furberg CD, Wright JT Jr, Cutler JA, Whelton P. ALLHAT Collaborative Research Group: ALLHAT: Setting the record straight. Ann Intern Med. 2004; 141: 39-46.