Diuretics are one of the basic groups of antihypertensive drugs. They have also certain limitations and undesirable effects which are better defined than in other more recently developed antihypertensives. Undesirable effects can be prevented by early combination of saluretics with K+ sparing diuretics or other antihypertensive drugs and by prevention of metabolic disorders (in particular insulin resistance and dyslipoproteinaemia) and by prescription of small doses. Only prospective intervention studies will show whether the advantages of other groups of antihypertensives, as compared with diuretics, will influence the prognosis of patients with essential hypertension in a substantial way. Several studies along these lines are under way.
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