Drug treatments: Diuretics

Blood pressure is influenced by how much water is in your body and salt intake. Diuretics reduce water and sodium in your body, and for decades have been the chief method for treating high blood pressure. They are still considered the first choice by many experts, especially for treating the elderly and African-Americans.

Diuretic types

Diuretics come in many brands and are generally inexpensive. Some need to be taken once a day, others twice a day. There are three primary types:

Problems with diuretics

The loop and thiazide diuretics can lower the body's supply of potassium, which, if left untreated, increases the risk for arrhythmias. Arrhythmias are heart rhythm disturbances that can, in rare instances, lead to cardiac arrest. If potassium levels are lowered, physicians will prescribe lower doses of the current diuretic, recommend potassium supplements, or use potassium-sparing diuretics.

Potassium-sparing drugs have their own risks, which include raising potassium to dangerously high levels, particularly in people who started out with somewhat high potassium or those with damaged kidneys.

Common side effects

Common side effects of diuretics are:

Potassium-sparing diuretics may increase the risk of bleeding in the stomach or intestines. Thiazide diuretics may raise cholesterol level or blood sugar -- therefore, these levels should be followed closely in people with high cholesterol or diabetes. Loop diuretics may also raise blood sugar.

Arrhythmias (abnormal heart rhythms) can occur because of changes in potassium levels in the blood, especially when the diuretic is taken with other medications (such as digoxin). Nonsteroidal anti-inflammatory drugs (like ibuprofen) may interfere with diuretics.

 


Review Date: 6/8/2011
Reviewed By: Steven Kang, MD, Division of Cardiac Pacing and Electrophysiology, East Bay Arrhythmia, Cardiovascular Consultants Medical Group, Oakland, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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