Posted on 03/16/2023 8:22:12 AM PDT by ConservativeMind
A new study finds biological sex and time of day makes a difference in the effectiveness of diuretics—medications commonly prescribed to manage high blood pressure.
The body's circadian clock and biological sex are two key factors in blood pressure management. The kidneys play a significant role in blood pressure regulation by managing fluid and electrolyte levels in the body. The body's circadian clock also regulates kidney function.
Researchers explored how time of day and biological sex affect how well diuretic medications work. These drugs act on different renal transporter proteins to increase the amount of urine the body excretes.
The research team used computational models of cells from male and female mouse nephrons—the functional unit of the kidneys—to examine the effects of three types of diuretics:
- Loop diuretics inhibit the sodium-potassium-chloride co-transporter. - Thiazide diuretics inhibit the sodium/chloride cotransporter. - Potassium-sparing diuretics inhibit the epithelial sodium channel and increase urine flow without causing potassium loss in the urine.
The research team's simulations represented active and inactive cycles of circadian rhythms. They found that in both sexes, loop diuretics were predicted to cause higher levels of urine output and sodium excretion during the active phase. There was very little change in urine output in females with thiazide diuretics but a marked increase in both urine volume and sodium excretion in males.
Treatment with potassium-sparing diuretics was found to cause substantially higher urine volume and sodium excretion during the active phase in females but not as much in males compared to the other diuretics.
Based on the findings, the researchers explained that changing when people take blood pressure medications—in the evening instead of the morning, for example—may make the treatment more effective.
(Excerpt) Read more at medicalxpress.com ...
Apparent takeaways:
1 - It is better to take diuretics in the evening.
2 - Women have the best sodium & urine output with loop or potassium-sparing diuretics.
3 - Men have the best sodium & urine output with loop or thiazide diuretics.
I will post, in the next comment, a webpage with examples of each type of diuretic.
As an aside, Angiotensin II Receptor Blockers (ARBs) are generally considered the best all-round blood pressure medicine, but calcium channel blockers and diuretics are good adjuncts to ARBs.
The newest/best ARBs off patent (with generics) appear to be telmisartan, followed by irbesartin. Various ARBs can positively or negatively influence other health conditions, with those two having really nice benefit/risk profiles.
diuretics are obviously transphobic then! because if some man identifies as a woman, his body should react as a woman does to diuretics!
*rolls eyes*
I’m confused! How am I supposed to know if I’m a man or a woman? I’m not a biologist!
Interesting! I was in a situation where I needed to increase my lisinopril for blood pressure issues. I had read a study that showed taking blood pressure meds before bed had much better results than in the morning. My doctor at the time wanted to put me on the lisinopril/hydrochlorothiazide combo pill but didn’t want me to take that combo before bedtime as it would increase the number of times I would have to get up in the middle of the night to urinate. So he basically has me taking the combo pill in the morning then just lisinopril in the evening. This was about 6 years ago.
Since then my blood pressure has been really good but my new doctor thought perhaps I could get off the nighttime lisinopril so she has me taking the cialis generic at 5mg to replace it. Cialis is also a blood pressure reducer along with other cardiovascular benefits. Seems to be working for me.
My biggest concern with the results of this study is taking a diuretic before bedtime increasing the number of times one would have to wake up to go to the bathroom in the middle of the night. Seems a good sleep would be more beneficial health-wise?
My thinking exactly. It's bad enough that I wake up 3-4 times a night as it is (not for prostate, just widower effect), but if I started taking my furosemide (loop diuretic) in the evening, I would never get any sleep.
“according to biological sex...”
What are you, some kind of bigot?
I think they were recommending a change in time for blood pressure medicine.
As I read it, the urine increase occurs during the day (active) time, for humans.
It may not do much during sleep.
Thanks for the summary. And good news for me I take nearly all my medicine at night.
But what about trans-men and trans-women. Which one works best for them. LOL.
Loop diuretics (example: furosemide) are fast-acting. Indeed, taking them at night would prompt multiple trips to the head.
I am intrigued why the authors think they wind up working only during the day, when taking them in the evening.
Thank you.
“Biological Sex” LOL.
I am intrigued that using a study sample of rodents, then inverting the findings based on nighttime rodent activity, is worthy of human recommendations.
I scanned this quick, but it seems to me that this is NOT a valuable article for people here, considering how things like this get interpreted and applied here.
The commentary article cited says “There was very little change in urine output in females with thiazide diuretics but a marked increase in both urine volume and sodium excretion in males.”
Fine, probably on the first few days only, in this study only done on a computer model.
In the actual medical publication, this was mostly a short term computer model of the kidney, trying to ARTIFICIALLY demonstrate how it and some typical bodies respond to three types of diuretics, when tried in two computerized sexes, at two different times of day, WHEN THE COMPUTER MODEL WAS PRE-SET UP WITH THE researcher’s PRE-EXISTING BIASES as to what all is going on with these things.
It’s a little self-fulfilling.
Computer models are good, but people with lives are too complicated to use this model to make madical decisions.
Articles like this are something like (to use a popular example here) guessing an RNA vaccine will be OK before it was tested much!
It is part of research and development, but does not replace real life, and there are many articles about real people taking real diuretics already.
So why does this line seem a problem? “There was very little change in urine output in females with thiazide diuretics but a marked increase in both urine volume and sodium excretion in males.” Let me reply with a question and answer
How much urine ultimately comes out of people who take a water pill (diuretic)?
Answer: The same amount that goes IN (what you drink), plus any edema (swelling) that was able to also be excreted (and once the edema is gone that will be zero), minus water you breath out, sweat out, vomit up, poop up, etc.
So after say 2 weeks for normal people with only blood pressure issues, the urine ourput is basically going to be almost exactly the same before and after the water pill unless the water pill ALSO makes you drink MORE water to chase the additional urine output, which is not always the case.
Water does not come from thin air, ultimately you pee a proportion of what you drink whether you are a man or a woman.
In real life, hormones and side aside, are men and women different in any other ways? Of course.
Work is different, different hours working, different time of day with different access to liquids, eat different foods, BEER tendencies even, body surface area and amount of sweat from that, you name it.
If the pills on their computer make the men pee more, then ultimately those men are drinking more also. At least for a few days.
And the men were saltier in the first place or they ate more salt to pee out at first, maybe both.
Neither water nor salt come out of thin air, people either took them in or they were already in their bodies.
So articles like this are basically “medical porn” that are something to looks at and talk about, but these articles are not good to use to make personal decisions about what to take and when, or what pills to like and not like.
Just 2¢ worth, there is so much stuff like this posted here I felt like commenting.
I may have missed some stuff in a scan of that article, but it’s easy to tell that it is not worthwhile for the average patient on FR reading this.
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