Often going by the name of "water pills," diuretics are a class of medications prescribed for high blood pressure. They lower the blood pressure by helping your body get rid of excessive water and salt through the urine for a healthy heart. Thiazide diuretics are most effective long-term. In case of emergency--such as congestive heart failure--loop diuretics and potassium-sparing diuretics are available. The 2003 Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure recommended thiazide diuretics to treat uncomplicated hypertension, "either alone or combined with drugs from other classes."
The findings from the 2008 study "Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial" show that thiazides offer greater protection against cardiovascular disease, including heart failure in patients with high blood pressure as part of metabolic syndrome. These patients have several risk factors for heart disease including increased blood pressure (130/85 mm Hg or higher), decreased HDL levels (high-density lipoprotein, the good cholesterol) and diabetes or pre-diabetes (fasting blood glucose of 100 mg/dL or greater).
According to the ALLHAT study, diuretics can be effective as a single-drug treatment for high blood pressure. In fact, diuretics appear to be as good as or better than other more expensive blood pressure drugs such as ACE inhibitors and alpha-blockers for someone with hypertension and metabolic syndrome. If you are suffering from metabolic syndrome and are taking several medications, make sure diuretics top your shopping list.
What to Look for
To get the most out of your medication, and to minimize potential side effects, you should be honest with your doctor at all times. Let him know if you are pregnant, breast-feeding and elderly or are already taking another over-the-counter (OTC) medication or herbal medicine. Also let him know if you are into alcohol or sleep-aids, which are best avoided while on water pills. Be sure to get your blood work done for electrolytes.
Common Pitfalls
Watch out for side effects following a dose of diuretic. These may include abnormal heart beat, fatigue or tiredness, muscle cramps, dizziness, lightheadedness, problems with vision, dehydration, fever, sore throat, cough, ringing in the ears, unusual bleeding or bruising, unexplained weight loss, skin rash and loss of appetite. Be sure to contact your physician right away if these problems arise. It may be that your body is just trying to adapt to the new regimen. Your doctor might advise several ways to address your concerns. For instance, you might be advised to take the pills in the morning instead of evening. Or combine with a low-sodium diet or a potassium supplement or potassium-rich foods, such as bananas, or avoid them altogether if you are taking potassium-sparing diuretics. You may also want to be physically active, and eat a diet low in saturated fat, cholesterol, while giving up smoke if you are a smoker.
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