To the Editor.
—I would like to disagree with one point in the recent article published in the Archives by Francisco and Ferris entitled "The Use and Abuse of Diuretics" (1982; 142:28-32). In this article, it is stated that diuretics are considered to be appropriate therapy for preeclampsia. Current concepts of preeclampsia indicate that the hypertension is caused by vasospasm, and the intravascular volume is decreased, even though extravascular volume is increased. I agree with the statement that diuretics and salt restriction should not be used to treat preeclampsia, because they may further decrease the already compromised placental perfusion.1 Although diuretics have been used extensively in the past, I believe that the current concepts of the pathophysiology of preeclampsia support the position that diuretics should rarely be used in the treatment of preeclampsia.
Smith RP. Diuretics and the Treatment of Preeclampsia. Arch Intern Med. 1982;142(8):1581. doi:10.1001/archinte.1982.00340210179034