Diuretics along with calcium channel blockers are first choices used by doctors to treat high blood pressure according to Recommendations 6 and 7 of JAMA8 guidelines. Jay Harold has written several posts on high blood pressure. This post will focus on “Hypertension & Diuretics: 4 Types and Side Effects.”
Diuretics are a type of drug that causes the kidneys to make more urine. Diuretics help the body get rid of extra fluid and salt. They are used to treat high blood pressure, edema (excess fluid in the tissues), heart failure1, liver cirrhosis2, hypertension, water poisoning3, and certain kidney diseases4. They are sometimes called “water pills.”
Types of Diuretics5
- Loop diuretics are diuretics that act at the ascending loop of Henle6 in the kidney, resulting in increased urine production. Loop diuretics decrease blood pressure. Bumetanide, furosemide, and torsemide (Demadex) are examples of loop diuretics.
- Osmotic Diuretics works by expanding fluid and plasma7 volume, increasing blood flow to the kidney. These agents can also act in other parts of the body. Mannitol is an example of an osmotic diuretics.
- Diuretic drugs that do not promote the secretion of potassium into the urine. Generally used in combination with other diuretic drugs (e.g., loop diuretics) that would otherwise tend to lower the potassium levels. Spironolactone, amiloride (Midamor), and triamterene (Dyrenium) is an example of Potassium-sparing diuretics.
- Thiazide diuretics are a type of drug used to treat high blood pressure, edema (extra fluid in the tissues), and other conditions. Thiazide diuretics cause the kidneys to make more urine, which allows the body to get rid of extra fluid and salt. Chlorothiazide (Diuril), chlorthalidone (Hygroton), indapamide (Lozol), hydrochlorothiazide (Esidrix, HydroDiuril), and metolazone (Mykrox, Zaroxolyn) are examples of thiazide diuretics.
When you are taking diuretics, you will need to have regular checkups so that your health care provider can check your potassium levels and monitor how your kidneys are working.
Diuretics make you urinate more often. Try not to take them at night before you go to bed. Take them at the same time every day.
Water Pills: The Good
Diuretics play an essential role in controlling many diseases that affect African-Americans. Diuretics are a preferred choice for hypertension according to the new JNC (Joint National Committee) 8 guidelines. Jay Harold has a post that addresses high blood pressure in African-Americans. The National Institutes of Health (NIH) has information about heart failure diagnosis, prevention, and treatment.
Water Pills: The Bad
Common side effects of diuretics are:
- Fatigue, muscle cramps, or weakness from low potassium levels
Diuretics are used to treat diseases such as high blood pressure and heart failure.
- Dizziness or lightheadedness
- Numbness or tingling
- Heart palpitations, or a “fluttery” heartbeat
- Gout
- Depression
- Irritability
- Urinary incontinence (not being able to hold your urine)
- Loss of sex drive (from potassium-sparing diuretics), or inability to have an erection
- Hair growth, menstrual changes, and a deepening voice in women (from potassium-sparing diuretics)
- Breast swelling in men or breast tenderness in women (from potassium-sparing diuretics)
- Allergic reactions — if you are allergic to sulfa drugs, you should not use thiazides.
Be sure to take your diuretic the way you have been told.
Weighing Yourself Regularly
You will get to know what weight is right for you. Weighing yourself will help you know if there is too much fluid in your body. You might also find that your clothes and shoes are feeling tighter than normal when there is too much fluid in your body.
Weigh yourself every morning on the same scale when you get up — before you eat and after you use the bathroom. Make sure you are wearing similar clothing each time you weigh yourself. Write down your weight every day on a chart so that you can keep track of it.
Call your doctor if your weight goes up by more than 2 to 3 pounds in a day or 5 pounds in a week. Also, call your doctor if you lose a lot of weight.
The Ugly: When to Call the Doctor
Call your health care provider if:
- You are tired or weak.
- You feel short of breath when you are active or when you are at rest.
- You are wheezing and having trouble breathing.
- You have a cough that does not go away. It may be dry and hacking, or it may sound wet and bring up pink, foamy spit.
Diuretics help reduce excess fluids in the body.
- You have swelling in your feet, ankles, or legs.
- You have to urinate a lot, especially at night.
- You have gained or lost weight.
- You have pain and tenderness in your belly.
- You have symptoms that you think might be from your medicines.
- Your pulse, or heartbeat, gets very slow or very fast, or it is not steady.
Jay Harold knows the potential problems with diuretics since he has taken diuretics for years. Working with your doctor to find the best diuretic for you is important to minimize side effects. Learn more about side effects by reading an article from Jay Harold on this topic. You have a responsibility to yourself and your family to maintain good health. Do everything you can to achieve this goal.
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Bibliography
- https://www.nhlbi.nih.gov/health-topics/heart-failure
- https://medlineplus.gov/ency/article/000255.htm
- https://en.wikipedia.org/wiki/Water_intoxication
- https://vsearch.nlm.nih.gov/vivisimo/cgi-bin/query-meta?v%3Aproject=medlineplus&v%3Asources=medlineplus-bundle&query=kidney+diseases
- https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0025451/
- https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0025452/
- https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0014603/
