plaspillen tegen hoge bloeddruk.*
plaspillen die al lange tijd, zonder bijwerkingen, gebruikt worden voor
vochtafdrijving blijken zeer effectief te zijn om in combinatie met andere
therapieŽn de bloeddruk te verlagen. Het zijn de plaspillen met de stoffen
amiloride en/of spironolactone. Deze stoffen zorgen dat meer natrium
uitgescheiden wordt via de urine waardoor minder natrium in het lichaam blijft.
Te veel natrium (van bijv. keukenzout) in het lichaam is een belangrijke oorzaak
van hoge bloeddruk.
alternative drugs can help patients with problems controlling blood pressure
inexpensive but widely overlooked drugs may help many patients who continue to
have high blood pressure despite taking standard blood pressure medications,
according to research by Indiana University School of Medicine scientists.
Howard Pratt, M.D., and his colleagues studied two compounds -- amiloride and
spironolactone -- in a group of African-American patients with high blood
pressure. African-Americans are disproportionately affected by high blood
pressure, and tend to retain more sodium in their bodies, which is linked to
high blood pressure. Amiloride and spironolactone are diuretics, or "water
pills," that have been available for many years but no longer get much
attention from prescribing physicians.
In the study of 98 patients, some were given one of the two drugs, some were
given both, some were given a placebo. All of the patients continued to take
their standard blood pressure medication. On average, blood pressures of the
patients taking either amiloride or spironolactone individually, or both drugs,
dropped significantly. There were no side effects. The study was published in
the issue of the journal Hypertension.
Uncontrolled blood pressure can lead to serious complications including heart
attack, stroke, and kidney failure. According to some estimates, nearly one in
three U.S. adults has high blood pressure.
The two drugs tested work by limiting the amount of sodium the kidneys reabsorb
or take back into the body during the process of producing urine.
"The kidneys do an incredible job of holding on to sodium, which was
important to the survival of our early ancestors who lived in a salt-poor world,
but today there's so much salt in the food we eat that the kidneys end up
holding onto too much sodium," said Dr. Pratt. The result, he said, can be
high blood pressure - also known as hypertension.
The kidney retains sodium in two general regions. Traditional diuretics reduce
the uptake of sodium at an early region, closer to where blood is filtered to
produce urine. A region more "downstream" also takes back sodium from
the urine. If too much is taken back in the first region, then the kidney
adjusts by taking up less sodium in the second region. But such an adjustment
doesn't always occur, with the result that the kidney ends up bringing too much
sodium back into the body. This problem may worsen with age, Dr. Pratt said.
Amiloride and spironolactone work on the late or downstream region. By
inhibiting the uptake of sodium there, "which is the last place in the
chain of events for getting it right, you can restore blood pressure to normal
levels in many patients when the drugs are used together with a standard
diuretic," Dr. Pratt said.
Dr. Pratt said that physicians with patients showing resistance to treatment -
patients for whom standard therapy doesn't result in a normal blood pressure -
tend to prescribe higher doses of the medicine already being used, or add in a
new blood pressure drug that could be expensive and often is also ineffective.
He said he expects that this and additional studies will convince physicians to
try the amiloride or spironolactone alternatives instead.
Dr. Pratt said the study was conducted with African-American patients because
they are on average more predisposed to retain sodium, but he believes the
effectiveness of the two drugs likely would be the same regardless of ethnicity.
The study was funded by a grant from the National Institutes of Health.(