February 1963

The Vascular Effect of the Thiazide Diuretics

Author Affiliations

From Department of Internal Medicine, University of Michigan Medical Center.; Associate Professor of Internal Medicine and Physiology and Established Investigator of the American Heart Association (Dr. Conway); Research Assistant in the Department of Internal Medicine (Dr. Palmero).

Arch Intern Med. 1963;111(2):203-207. doi:10.1001/archinte.1963.03620260063011

While it seems likely that the fall in blood pressure produced by the thiazide diuretics is a consequence of their sustained diuretic action, it has not been possible to demonstrate this with certainty, and the mode of action of diuretics in reducing blood pressure remains unexplained. Although there is a reduction in extracellular fluid and plasma volumes over the first few days after the drug is administered,1-3 these are later restored to their initial levels.4-7 Furthermore, it has been shown that cardiac output, though initially reduced, returns to normal levels after a period of weeks of continued therapy. Since the blood pressure continues to be reduced, the calculated total peripheral resistance is also reduced, and it has been inferred that the drug affects the blood vessels themselves.6 The purpose of this report is to acquire direct evidence by plethysmography for this action on the peripheral blood vessels

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