Diuretics are usually prescribed as a first-line treatment for high blood pressure, though many people require additional drugs for blood pressure management, such as beta blockers, ACE inhibitors, or angiotensin-receptor blockers (ARBs). Diuretics help lower blood pressure by reducing the amount of sodium and water in the bodyâ??the lower the volume of fluid in the bloodstream, the less pressure there is on the walls of the arteries. They’re also prescribed for kidney disorders, liver disease, and fluid retention caused by heart failure.
There are three main types of diuretics
Kidneys consist of millions of tiny winding tubes (tubules).
1.
Loop diuretics
act on a particular “loop” in these tubules.
2.
Thiazide diuretics
act on a different part of the kidney tubules but achieve the same result as loop diuretics: they cause the kidneys to increase the amount of salt and water in the urine. But both of these types of diuretics may deplete your potassium levels, and this can increase the risk of abnormal heart rhythms.
3.
Potassium-sparing diuretics
leave more potassium in the blood. However, this may cause potassium levels that are too high, which can also cause potentially deadly heartbeats. There are other side effects to consider as well, including frequent urination, lightheadedness, and fatigue.
So how do you know which is right for you?
Cardiologist Dr. Thomas Lee, co-editor in chief of the Harvard Heart Letter, says he starts most diuretic therapies with 12.5 milligrams of a thiazide diuretic. “It’s unlikely to cause potassium or other problems. If I have to go up to get good blood pressure control, I am more likely to go to a combination with one of the potassium-sparing drugs. I don’t use furosemide for blood pressure because it doesn’t last long,” he explains.
Diuretics |
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| Drug class | Generic name (brand name) | Action | Side effects | Warnings/interactions |
| Thiazide diuretics | chlorothiazide (Diuril);
chlorthalidone (Hygroton); More Top Picks Best Handheld Massagers For Back Pain For Men indapamide (Lozol) |
Targets kidney tubules
to stop sodium from re-entering bloodstream |
Weakness, confusion, fatigue,
thirst, frequent urination, lightheadedness, muscle cramps, diarrhea or constipation, impotence |
Potassium depletion,
increased sensitivity to sunlight, allergic reaction in Loop people allergic to sulfa drugs |
| Loop diuretics | bumetanide (Bumex);
ethacrynic acid (Edecrin); furosemide (Lasix) |
|||
| Potassiumsparing diuretics | amiloride (Midamor);
triamterene (Dyrenium); spironolactone (Aldactone) |
Causes more
sodium and water to be excreted in the urine; leaves more potassium in the blood |
Frequent urination, upset
stomach, vomiting, diarrhea, dizziness, breast enlargement and erectile dysfunction in men; menstrual irregularities More Top Picks Best Walking Shoes For Achilles Tendonitis in women |
Excessive potassium levels,
especially in patients with kidney disease |