High blood pressure (hypertension)

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Diuretics

Uses for diuretics

A large group of medical experts known as the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure recommends that most people should try thiazide diuretics as the first choice to treat high blood pressure and heart problems related to high blood pressure. If diuretics alone aren't enough to lower your blood pressure, your doctor may also recommend adding medications such as beta blockers, angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers to your blood pressure treatment.

In addition, doctors prescribe certain diuretics to prevent, treat or improve symptoms in a variety of conditions, such as:

  • Heart failure
  • Tissue swelling (edema)
  • Polycystic ovary syndrome
  • Certain kidney disorders, such as kidney stones
  • Diabetes characterized by frequent urination (diabetes insipidus)
  • Male-pattern hair growth in women (female hirsutism)
  • Osteoporosis

Side effects and cautions

Diuretics are generally safe, but do have some side effects. The most common side effect of diuretics is increased urination. This occurs most frequently in people taking loop diuretics. For some people, this side effect improves within a few weeks of taking a diuretic. People who take diuretics may also have too much potassium in their blood (hyperkalemia) if they take a potassium-sparing diuretic, or too little potassium in their blood (hypokalemia) if they take a thiazide diuretic.

Other side effects of diuretics may include:

  • Low sodium in your blood (hyponatremia)
  • Increased blood sugar
  • Increased cholesterol
  • Rash
  • Joint disorders (gout)
  • Impotence in men
  • Menstrual irregularities
  • Breast enlargement in men (gynecomastia)
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References
  1. Kaplan NM, et al. Thiazide versus loop diuretics in the treatment of hypertension. http://www.uptodate.com/index. Accessed Nov. 12, 2008.
  2. Chobanian AV, et al. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. New England Journal of Medicine. 2003;289:2560.
  3. Initial antihypertensive therapy: Drugdex Consults. Micromedex Healthcare Series. http://www.micromedex.com/. Accessed Nov. 12, 2008.
  4. Blood pressure-lowering drugs. American Heart Association. http://www.americanheart.org/presenter.jhtml?identifier=159. Accessed Nov. 12, 2008.
  5. Sheps SG, ed. Mayo Clinic 5 Steps to Controlling High Blood Pressure. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2008:184.

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Dec. 17, 2008

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