Lifestyle changes aren't always enough to lower high blood pressure. If so, prescription medicine may be the next step. According to the American Heart Association, if your systolic blood pressure (top number) is 140 or greater, your doctor may prescribe medication along with the lifestyle changes. Many different types of blood pressure medications are available. Even so, a diuretic, or water pill, may be among the first options that your doctor recommends.
The diuretics most commonly prescribed are called thiazides. Potassium-sparing diuretics are another type that may be prescribed. Diuretics help your blood pressure go down by helping your body to get rid of extra water and salt by producing more urine. They are sometimes combined with other medications to work more effectively.
Some over-the-counter medicines or herbal remedies also may help flush extra fluid from your system. But, they aren't alternatives to prescription diuretics.
Most people who take diuretics don't experience any problems, but side effects, such as dry mouth or a worsening of gout, are possible. Dizziness is another possible side effect, more common in the elderly; it can occur if a person loses too much water or if the person's blood pressure is too low.
Some diuretics also may remove potassium from the body. This may cause weakness, muscle cramps or fatigue. Your doctor may suggest that you take supplements or eat more potassium-rich foods, such as bananas, dates, figs, spinach, avocados, or tomatoes. Before taking any supplement or changing your diet, however, talk with your doctor. This is especially important if you're taking other medications that potentially could interact with a new drug or be affected if you change your diet. If your doctor prescribes a potassium-sparing diuretic, for example, extra potassium isn't necessary and may even be dangerous.
Diuretics may also increase the amount of sugar in the blood.
It's important to take a diuretic at the same time every day. If you have trouble remembering to take your medication, it may help to use a pillbox, write a note, use your watch alarm , or a smartphone app or alarm to alert you when it's time for a dose. It is also best to take a diuretic in the morning, so you are not up frequently during the night to use the bathroom. If you suspect you may be having a side effect, don't stop taking your diuretic. Talk with your doctor. He or she just may need to adjust your prescription.
- MMI board-certified, academically affiliated clinician
- Turley, Ray, BSN, MSN