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From: wurzelma@aecom.UUCP (John Wurzelmann)
Newsgroups: net.med
Subject: Re: Re: Thiazide diuretics & blood lipid level
Message-ID: <2056@aecom.UUCP>
Date: Fri, 15-Nov-85 16:46:14 EST
Article-I.D.: aecom.2056
Posted: Fri Nov 15 16:46:14 1985
Date-Received: Sat, 16-Nov-85 07:27:53 EST
References: <547@nbires.UUCP> <2055@aecom.UUCP>
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Organization: Albert Einstein Coll. of Med., NY
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> 
> 	To repeat, according to MRFIT, Diuretic use in patients with 
> borderline hypertension (90-95 diastolic) and existing cardiac arrythmias
> (EKG abnormalities) can aggravate this and lead to an increased risk of
> sudden death. The mechanism is loss of Potassium with the Sodium.  These
> patients should be (and are) put on Potassium-sparing diuretics instead.
> If no such electrical abnormality exists, then there is no risk.  Or, if
> blood pressure is higher, the risk of BP complication far exceeds the added
> risk (which is now avoided in current practice -- after all, doctors read
> these studies too, you know.)
> 

	Craig, the M.R.F.I.T. study does hint at the conclusions which you
summarize, but it does not state them with anywhere near the conviction that
you do. Rather the M.R.F.I.T. study offers the above notion as a hypothesis
to explain the relatively small excess of deaths which occurred in the
intensively treated study group. This hypothesis is by no means proved and
should not be forth as fact.


					       Sincerely,
						John Wurzelmann