对于临床医生来说,了解下述问题是很重要的:①服利尿剂患者适当限钠会不会减少钾的丢失?②各种利尿荆的降压作用和丢失钾的情况,有否不同之处?Ram 的观察表明:氯噻酮——一种长效的利尿药不仅比短效利尿剂——速尿的降压幅度大,且钾丢失也较多。双氢克尿噻——一种介于上述两药之间的中效利尿剂,其降压作用与氯噻酮同,但引起钾的丢失较少。上述结果,与新近一些文献的报告相同,因而,推荐给大多数之高血压患者,开始时,宜用中效或长效利尿剂治疗。适当地限钠,是否能加强利尿药的降压作用?众所周知,严格地限钠(<0.5g/d),便能有效地使大部分高血压患者血压降低。然而多数患者对此不能耐受,且多数医生亦不想过于勉强病人。据晚近文献初步报告:适当地限钠,每天摄入钠2～3g,也能使轻 For clinicians, it is important to understand the following questions: â’¡ proper diuretic patients with limited sodium will not reduce the loss of potassium? Â ’¡various antihypertensive effect of vasopressin and potassium loss, whether there is any difference Ram? Observations showed that: Chlorthalidone - a long-acting diuretic than short-acting diuretic - furosemide buck pressure range, and more potassium loss. Hydrochlorothiazide - a mid-range diuretic between the two drugs, its antihypertensive effect with chlorthalidone, but caused less loss of potassium. The above results, as reported in recent literature, are therefore recommended for the majority of hypertensive patients and should initially be treated with moderate or long-acting diuretics. Appropriate sodium restriction, whether to step up the antihypertensive effect of diuretics? As we all know, strictly limited sodium (<0.5g / d), can effectively reduce the blood pressure in most hypertensive patients. Most patients, however, can not tolerate it and most doctors do not want to overly reluctantly. According to a recent preliminary report of the literature: proper sodium limit, daily intake of sodium 2 ~ 3g, but also to light