Diuretics

• Diuretics reduce sodium in the body
  
  Depending on the severity of your blood-pressure elevation, your doctor may suggest a diuretic as your first medication. These are often referred to as water pills. The purpose of diuretics in blood-pressure control is to reduce the body's sodium level. They work by inhibiting the kidney's ability to reabsorb sodium, enhancing the excretion of sodium, or by blocking the exchange of sodium. If the diuretic is the type that blocks the sodium exchange, it results in very little loss of potassium; these types are called potassium-sparing diuretics. It is important to know whether your diuretic results in potassium loss; if it does, you may require potassium supplements and regularly scheduled blood tests.
  
  

Medication Combinations

• You may need more then one medication
  
  When diuretics are not sufficient to lower your blood pressure, your doctor may suggest an alternative medicine or perhaps an additional one to add to your regimen. It is common to use a combination of medications for hypertension. Using smaller amounts of two or more medications will not only reduce the chance of side effects; it may also allow for a synergistic effect so that they all work better together. Common medications are ACE inhibitors and angiotensin receptor blockers, beta blockers, calcium channel blockers and alpha blockers. As these medications all work differently, it may take more than one trial to see which combination works best for you.
  
  

Medication Compliance

• Compliance and life style changes are important
  
  Because high blood pressure often has no symptoms, it is easy to neglect taking medications or to assume you no longer need them. If the medication is causing side effects, there is an increase of noncompliance. It is important, however, to never stop or reduce the dose of any medication without first consulting the doctor who prescribed it. Expensive medications (such as angiotensin receptor blockers, commonly known as ARBs), may also result in noncompliance if they are not covered by your insurance. Doctors' offices often have samples available that are provided by the drug companies. In addition, most pharmaceutical companies have patient-assistance programs that can help with the cost.