| The wide range of antihypertensives in the | | | | Low potassium levels, a condition called |
| market is likely to confuse the patient. How do | | | | hypokalemia, have been linked to arrhythmias or |
| they differ from one another? What is the best | | | | irregular heart beats. Researchers believe this was |
| one for you? The following guide will hopefully give | | | | the cause of death of some male hypertensive |
| you a better understanding of these drugs and | | | | patients in Australia who received diuretics without |
| make things easier for you. | | | | potassium supplementation. |
| Diuretics are the earliest drugs for hypertension | | | | On the basis of this and other findings, Dr. Hamid |
| that have been around since 1957. Many doctors | | | | Ikram, head of the Department of Cardiology at |
| prescribe them first and over 15 million Americans | | | | the Princess Margaret Hospital in Christchurch, |
| use them. They lower blood pressure by | | | | New Zealand said that "diuretic therapy may |
| increasing the rate at which sodium and water are | | | | shorten lifespan." |
| eliminated from the body. | | | | There are other ways in which diuretics can make |
| The main advantage of diuretics is their low price. | | | | life miserable for you. While they can effectively |
| Patients don't' have to spend much while using | | | | lower blood pressure, they do not decrease the |
| them. The bad news is that they have a lot of | | | | incidence of heart attacks. This is probably |
| side effects. | | | | because diuretics have the nasty ability of raising |
| "One man in three who take diuretics becomes | | | | the blood's cholesterol level, making the patient |
| impotent. These agents often raise blood sugar | | | | susceptible to heart disease. |
| (which, however, returns to normal when you | | | | "Statistically speaking, when, blood pressure has |
| stop the drug). They elevate uric acid levels in the | | | | been lowered by a diuretic, the incidence of heart |
| blood, and a high uric acid causes gout so that if | | | | attacks is not decreased. We used to think that |
| you're vulnerable, you may wake up one morning | | | | as long as your blood pressure stayed down, no |
| with a big red, swollen, painful toe. They can upset | | | | matter what medication was used, the risk of |
| an empty stomach (so always have your diuretic | | | | heart attack was reduced. That appears to be |
| with food or milk). And then there's the matter of | | | | true for almost every antihypertensive drug |
| voiding. Diuretics are usually taken once a day, | | | | except the diuretics. In other words, when blood |
| either with breakfast or at bedtime. A morning | | | | pressure has been normalized by using diuretics, |
| dose will keep you 'running' all day; taken at | | | | the incidence of stroke is decreased, but not the |
| bedtime you're likely to get up every hour or so | | | | incidence of heart attacks," Rosenfeld warned. |
| during the night to empty your bladder," said Dr. | | | | "For all these reasons, I prefer not to prescribe |
| Isadore Rosenfeld of the New York Hospital - | | | | diuretics as first-line drugs in white hypertensive |
| Memorial Sloan - Kettering Cancer Center in "The | | | | patients. However, despite their drawbacks as |
| Best Treatment." | | | | antihypertensives, they do have an important |
| But that's not all. While increasing the elimination of | | | | place in the treatment of heart failure, whenever |
| salt and water from the body, diuretics may rob | | | | the body retains fluids and in certain |
| you of valuable minerals like potassium and | | | | 'sodium-sensitive' forms of high blood pressure, |
| magnesium. This can leave you weak and | | | | especially common in blacks," he added, (Next: |
| confused. | | | | Beta-blockers for hypertension. |