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The blood pressure drugs colloquially known as "pee pills" are the world's most popular treatment for high blood pressure.

Performance of Diuretic Blood Pressure Drug Illustrates "You Get What You Pay For"

Encouraging the kidneys to remove water from the blood, along with the electrolytes needed to power the heart, diuretic drugs, especially a diuretic drug called hydrochlorothiazide (HCTZ) are prescribed to as many as three-fourths of all patients who need treatment for high blood pressure.

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And since HCTZ and another water-removing called Lasix (furosemide) only cost pennies to make and are typically sold to patients for $4 a month, the less money you have, the more likely you are to get these drugs. But do they really work?

The problems with HCTZ. Hydrocholorothiazide is widely available as a generic drug and also sold under the trade names Aquazide H and HydroDIURIL. There is no doubt that it removes fluid and lowers blood pressure. The problem is that it also makes arteries stiffer. This means that should a blood clot form, the body's natural defense systems, that keep the clot from blocking an artery by making the arteries wider, can't work as well. And since HCTZ also causes potassium to be removed from the bloodstream, part of the way it makes the blood pressure lower is by making the heart weaker.

Combining HCTZ with ACE-inhibitors or ACE-receptor blocker medications keeps potassium in the bloodstream, but it does not help the arteries relax. And the amount of blood pressure reduction that HCTZ actually accomplishes is quite low, in most cases no more than 5-8 mm Hg.

The problems with Lasix. In the United States, nearly everyone who has had a heart attack or who has angina is given a stronger diuretic sold under the trade name Lasix, or the generic name furosemide. Lasix is a little more effective for lowering blood pressure, but it also depletes the body of potassium. Moreover, it depletes the B vitamins, magnesium, and zinc. Taking Lasix can interfere with bone health, and even cause vitamin B deficiencies that manifest themselves as forgetfulness and double vision. Taking a magnesium or vitamin B supplement quickly corrects these side effects, in just a few hours, but Lasix, like HCTZ, also keeps the arteries stiff. Fortunately, diet may offer a better way to manage high blood pressure.

Should You Really be Taking a Diuretic for High Blood Pressure?

Since HCTZ and Lasix deplete electrolytes (which weakens your heart) without doing a lot to lower your blood pressure, they certainly should not be taken alone. You may need a second medication to stop the side effects of these diuretic drugs! But is it possible to manage high blood pressure without using any diuretic drugs at all?

There is good evidence that instead of taking a diuretic to subtract sodium from your body, you might get more benefit from eating more fruits and vegetables to add potassium to your body. The famous DASH studies have found real benefits to eating at least five, and preferably nine, servings of fruits and vegetables every day. The effect on blood pressure is not dramatic, just 5 to 10 points, but there are no side effects, and arteries become more flexible, not less.

Don't stop taking any blood pressure medication without consulting with your doctor first. And be advised that if you have congestive heart failure, you may need a diuretic to help keep fluid off your lungs.

But see if adding fruits and vegetables to every meal doesn't help lower your blood pressure. The only precaution you must take is to check with your doctor or pharmacist to make sure you are not taking another medication that can cause potassium to build up in your bloodstream. If you are not taking a "potassium-sparing" medication, then eating more plant foods will surely help you lower your blood pressure.