Adverse renal effects of hydrochlorothiazide in rats with myocardial infarction treated with an ACE inhibitor

The Role of Chlorthalidone in Patients With High‐Risk Hypertension

“…Thiazide diuretics, when added to an ACEI in rats post-myocardial infarction, have been shown to have a detrimental effect on renal function and structure compared with an ACEI alone. 7 Thiazide diuretics have also recently been shown to increase the ratio of visceral to subcutaneous fat, 8 which has important long-term implications for vascular and myocardial inflammation and fibrosis, as well as for the development of diabetes mellitus. Thiazide diuretics have not been shown to improve the availability of NO or to improve endothelial function, 9 whereas both an ACEI and amlodipine improve NO availability, with the combination being more effective than either alone.…”