Hypertension (HTA), whether systolic and diastolic or as isolated systolic hypertension, has been firmly established as a major risk factor of morbidity and cardiovascular mortality in elderly patients. Despite recent controversies that have appeared in the literature on the metabolic disturbances caused by diuretics, especially hypokalemia, and the absence of a significant advantage on coronary mortality, these drugs should nevertheless be considered as extremely important in the treatment of HTA. Prescribed at small doses, their long-term effects are by far the best documented of all antihypertensive drugs. Their mechanisms as well as their main side effects are described below. Finally, the authors give some simple guidelines on their use, more specifically in elderly patients.
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