Dr.Armughan Riaz
M.B.B.S, Dip Card
Consultant Cardiologist


Role of Diuretics in High Blood Pressure

Role of Diuretics in High Blood Pressure, Diuretics may be used to treat a number of heart-related conditions, including high blood pressure, heart failure, kidney and liver problems, and glaucoma.

Role of Diuretics in High Blood Pressure

Substances that augment "diuresis," or the removal of fluids from the body through urination, are considered diuretics. More commonly known as "water pills," diuretics may be prescription or over the counter drugs. Diuretics may be used to treat a number of heart-related conditions, including high blood pressure, heart failure, kidney and liver problems, and glaucoma.When used as monotherapy to control high blood pressure, are effective in 30-40% of patients.

There are basically three typres of diuretics.
Thiazide diuretics like Diuza
Loop Diruretics like  Lasix
Potassium sparing diuretics Aldactone,  Spiromide

These are extremely inexpensive and are considered as very effective in controlling blood pressure in elderly patients. Main side effects of diuretics are metabolic disturbances. They cause loss of potassium that can lead to heart rate problems, however if used in low doses, usually prevent hypokalemia.  Thiazide diuretics may induce gout in gout prone individuals, as these cause increase uric acid level in body.

Now come to loop diuretics like Frusimide Lasix, are poor antihypertensive drugs, as there action is short acting. These should be used for management of fluid overload. No outcome data are available for these agents in high blood pressure.

Potassium sparing diuretics like Spironolactone inhibits aldosterone and are weak diuretics. These are basically used in conjunction with a thiazide or loop diuretic to conserve potassium. If you are using ACE inhibitor drugs along with these drugs, then you should monitor your potassium level carefully.

Guidelines for Taking Diuretics

Here are some general guidelines if you're taking a diuretic:

  • Follow your doctor's instructions on how often you should take the diuretic. If you are taking a single dose a day, it might be better to take it in the morning instead of at night, so that you will not have your sleep interrupted by frequent trips to the bathroom. (This is more pertinent for patients with congestive heart failure or patients with cirrhosis and portal hypertension.)
  • While taking a diuretic, have your blood pressure and kidney function tested regularly, as advised by your doctor.
  • Keep all appointments with your doctor and the laboratory so that your response to this drug can be monitored.Before a diuretic is prescribed, tell your doctor if you are taking any other medications that may have been prescribed by another physician or any over-the-counter or herbal remedies. Also, tell your doctor if you have any other medical problems.


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