ABSTRACT
Torasemide is a loop diuretic and has been used for the treatment of both acute and chronic congestive heart failure (CHF) and arterial hypertension (AH). Torasemide is similar to other loop diuretics in terms of its mechanism of diuretic action. It has higher bioavailability (>80%) and a longer elimination half-life (3 to 4 hours) than furosemide. In the treatment of CHF torasemide (5 to 20 mg/day) has been shown to be an effective diuretic. Non-diuretic dosages (2.5 to 5 mg/day) of torasemide have been used to treat essential AH, both as monotherapy and in combination with other antihypertensive agents. When used in these dosages, torasemide lowers diastolic blood pressure to below 90mm Hg in 70 to 80% of patients. Antihypertensive efficacy of torasemide is similar to that of thiazides and related compounds. Thus low-dose torasemide constitutes an alternative to thiazides in the treatment of essential AH.
Subject(s)
Blood Pressure/drug effects , Heart Failure/drug therapy , Hypertension/drug therapy , Loop of Henle/drug effects , Renin-Angiotensin System/drug effects , Sulfonamides/pharmacology , Biological Availability , Chronic Disease , Dose-Response Relationship, Drug , Half-Life , Heart Failure/metabolism , Heart Failure/physiopathology , Humans , Hyperglycemia/chemically induced , Hypertension/metabolism , Hypertension/physiopathology , Hypokalemia/chemically induced , Loop of Henle/metabolism , Loop of Henle/physiopathology , Sodium Potassium Chloride Symporter Inhibitors/pharmacology , Torsemide , Treatment OutcomeABSTRACT
The prevalence of right ventricular cardiac failure (CF) and its characteristics were analysed in 326 hospitalized elderly patients with chronic obstructive pulmonary disease (COPD) (average age 70+/-11 years). At admission right ventricular CF was diagnosed in 107 (33%) patients with COPD; its prevalence did not depend to sex but increased with age, especially among men. In patients with COPD right ventricular CF was associated with atrial fibrillation, anemia and obesity as well as a history of myocardial infarction. In patients with right ventricular CF dimensions of right ventricle and left atrium were significantly larger than those in patients without CF. Right ventricular CF was often associated with dilation of right atrium and pulmonary hypertension, especially with severe pulmonary hypertension. These data suggested that age (especially among men), pulmonary hypertension, atrial fibrillation, anemia, obesity and probably a history of myocardial infarction are risk factors for right ventricular CF in hospitalized elderly patients with COPD.
