The word diuresis is derived from the Greek word ourein which means ‘’to urinate’’. The diuretic agents are not only involved in the excretion of water but also capable to remove or excrete other urinary constituents which may be beneficial in the treatment of different conditions like hypertension, edema. Diuretic agents reduce morbidity and mortality related to stroke and congestive heart failure in hypertensive patients.

Hypertension can be defined as sustained increase in systolic blood pressure greater than 140 mmHg and diastolic pressure greater than 90 mmHg. Generally hypertension is classified into two types, based on the causes i.e., Primary hypertension of unidentified etiology and secondary hypertension due to any disease state or drug use. Dietary salt intake, kidney function, smoking, obesity and effect of hormones are the factors which may initiate hypertension.

So diuretic agents are used to remove excess fluid and electrolyte that have been retained in the body, specifically the excretion of sodium, chloride and bicarbonate. These are those ions which are largely restricted in diوٴerent conditions. Although diuretics may also be employed for irrigating the urinary passages with water, for promoting dehydration, or for establishing a normal urinary output in oliguria states. In actual practice it turns out that all of the useful diuretics produce their effects by interfering with the reabsorption of sodium from the tubular lumen. Diuretic agents differ in their mode of action, pharmacodynamics and pharmacokinetic properties.

It is frequently noted in hypertensive patients that continuous reduction of blood pressure with antihypertensive agents other than diuretics will result in an accumulation of extracellular fluid. In this case, the arterial blood pressure apparently has been forced below a level at which the hypertensive kidney can maintain homeostasis of the ECF. Electrolyte imbalance and dose-related reversible or irreversible ototoxicity may complicate treatment with loop agents. Reported idiosyncratic reactions to diuretics include interstitial nephritis, non-cardiogenic pulmonary edema, pancreatitis, and myalgias.

Thiazide and loop diuretics were associated with increased gout risk, an association mediated by a change in serum urate. Therefore nowadays, a development has been seen in uncontrolled hypertension due to non-adherence to diuretic agents by patients. Uncontrolled hypertension can further promote the risks of cardiovascular diseases. Therefore, currently focus is being shifted towards herbal treatment because herbs can grant positive therapeutic effects, are safer to use and is cost effective therapy.

Current Issue: Volume 8 Issue 1

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