Are Thiazide Diuretics the Right Medication for Blood Pressure?
Diuretics are drugs designed to cause the kidneys get rid of some of the excess salt in the body as there is a strong relationship between high blood pressure and a high content of salt in our system. As a result, diuretics tend to lower blood pressure, although they don’t always do a good job in this area.
Diuretics
The most widely employed class of diuretics, thiazide diuretics, are not very powerful as antihypertensive drugs. Not many people can control their blood pressure just with a thiazide alone, unless their only problem is salt and water retention. The antihypertensive effect of thiazides may take several weeks to work, way after the loss of salt and water has occurred.
Thiazide Diuretics in the market
| DIURETICS – THIAZIDE |
| Generic Ingredient: Chlorothiazide Brand names: Diuril |
| Generic Ingredient: Chlorothalidone Brand Names: Thalitone |
| Generic Ingredient: Hydrochlorothiazide Brand Names: Carozide, Esidrix, Ezide, Hydro-Par, Loqua, Microzide, Oretic |
| Generic Ingredient: Hydroflumethiazide Brand Names: Saluron |
| Generic Ingredient: Indapamide Brand Names: Lozol |
| Generic Ingredient: Methyclothiazide Brand Names: Enduron |
| Generic Ingredient: Metolazone Brand Names: Zaroxolyn |
| Generic Ingredient: Polythiazide Brand Names: Renese |
Thiazide diuretics are prescribed for several health conditions
- Edema associated with congestive heart failure (CHF)
- Cirrhosis of the liver
- Kidney malfunction
- Hypertension (high blood pressure)
- Other conditions where it is necessary to rid the body of excess water
Side effects of Thiazide diuretics
In people with diabetes, thiazides may increase blood sugar. They also may aggravate lipid disorders and cause substantial potassium loss. This potassium loss can cause serious heart rhythm disturbances if it is not recognized and treated, and may trigger attacks of gout. These side effects are not commonly seen on low doses, which are often enough for the treatment of hypertension.
- They increase urine production by affecting the movement of sodium and chloride in the kidneys
- They reduce sodium, magnesium, bicarbonate, chloride, and potassium levels
- Calcium elimination is moderated
- Uric acid is retained as a result of thiazide treatment
- They may also raise blood sugar
- May increase insulin requirement
- They can aggravate lipid disorders ; they can raise Total and LDL cholesterol , the bad guy and lower HDL cholesterol, the good one
These diuretics are often taken with other drugs to treat high blood pressure.
Thiazide diuretics deplete the body of basic minerals
- The thiazide diuretics cause both the excretion of sodium and potassium. Too little potassium in our muscles causes mild weakness, a very common side effect of diuretics.
- The extra loss of potassium through the kidneys can also result in a lower level of potassium in the blood. The irony is that a lack of potassium is part of the original problem in the development of hypertension or high blood pressure.
- Prolonged use of thiazide diuretics leads to a loss of magnesium which can, in turn, make difficult for the body to restore potassium. Low levels of potassium and magnesium in the blood can cause severe irregularity of the heart beat which can lead to sudden death. Magnesium is a mineral needed to respond to calcium. A deficiency in calcium can predispose to hypertension.
More side effects of thiazide diuretics
- Thiazide diuretics have been shown to raise blood sugar, total cholesterol, LDL cholesterol, the “bad” guy, and triglyceride levels, all high risks for a heart attack. People with diabetes may experience increased blood-sugar levels and will need to adjust the dosage of their anti-diabetic medication.
- Thiazide diuretics may also precipitate kidney failure in patients with advanced kidney disease.
- People with severe liver disease should be treated carefully with diuretics because minor changes in electrolyte balance may cause hepatic coma.
- Another complication of the thiazide diuretics is elevation of the blood uric acid level which can lead to an attack of gout.
Special information
Usually, diuretics are prescribed early in the day to prevent nighttime urination from interfering with sleep. Thiazide diuretics cause excess urination at first but it subsides after several weeks.
Contact your doctor if you develop the following symptoms:
- Muscle pain
- Sudden joint pain
- Weakness
- Cramps
- Nausea
- Vomiting
- Restlessness
- Excessive thirst
- Tiredness
- Drowsiness
- Increased heat or pulse rate
- Diarrhea
- Dizziness.
Avoid alcohol and other medications while taking a thiazide diuretic, unless directed by your doctor.
Avoid over the counter medications for the treatment of coughs, colds, and allergy if you have hypertension or CHF because such medication may contain stimulants.
Thiazide diuretics may cause sensitivity to sunlight. Use sunscreen and wear protective clothing if necessary.
Food interactions
Thiazide diuretics may be taken with food if they upset your stomach. Your doctor may recommend foods high in potassium like bananas and orange juice to offset the loss of potassium caused by these drugs.
Final word
If you have high blood pressure, the first step to take should be restricting the salt you ingest, since taking a diuretic while your diet is high in salt won’t work. In addition, taking diuretics has its own problems when it comes to side effects.
Do not, however, stop taking any blood pressure medication without the approval of your doctor. Follow a healthy diet, low in salt and rich in fruits and vegetables, and you may find that your blood pressure starts dropping. When your doctors sees that too, he will either lower your medication doses or will discontinue it. Not a bad outcome!
To your good health!
Emilia Klapp, R.D., B.S.
www.TheDiabetesClub.com
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