Diuretic tablets for high blood pressure: list of drugs, mechanism of action and contraindications

Diuretics for hypertension have been actively used in medical practice for more than 50 years, as they remove excess fluid and salts from the body. Blood pressure levels and kidney health are linked. When vascular tone is disturbed, fluid retention occurs, which provokes swelling and narrowing of the lumens in the vessels. Against the background of this condition, blood pressure rises.

If no measures are taken, the vessels gradually become thin, constant spasms occur, which is the cause of arterial hypertension. In this case, diuretics (diuretics) reduce the amount of intravascular fluid and reduce cardiac workload: this is why diuretics reduce blood pressure.

In the treatment of hypertension, diuretics reduce the likelihood of stroke and myocardial infarction.
But diuretics are only an aid in treatment , and relieve only the symptoms of the disease, therefore complex therapy should be prescribed and monitored exclusively by a specialist. Excess fluid is eliminated through the kidneys with urine.

With long-term use of diuretic drugs, the body adapts to a constant reduction in fluid volume, but blood pressure levels remain reduced as resistance to blood flow weakens. We can conclude that diuretics are a necessary step in the treatment of high blood pressure. In case of acute heart problems, diuretics should be carefully selected only with a doctor.

Mechanism of action

The clinical effect is based on the ability of diuretics to increase the excretion of fluid from the body. This is achieved through several points. Mainly due to complex biochemical processes that occur in the body and determine adequate filtration.

Without going into complex physiological features, the main effects can be outlined as follows:

• Reduced filtration quality. Primary urine comes out in large quantities, so the volume of circulating fluid drops significantly. How much depends on the power of the drug and the concentration of water in the patient’s body. The more of it, especially excess, the more pronounced the effect.
• Reducing blood viscosity, normalizing volumes. With an excessive amount of fluid in the body, the load on the cardiovascular system increases. The myocardium is overloaded.

Depending on your health condition, this can lead to different consequences. From simple tachycardia in a relatively healthy person to severe cardiac failure, severe complications, even stopping the functioning of a muscle organ.

Diuretics can normalize the condition and eliminate the side load on the heart.

• Reduced blood pressure. This is the result of the same change in the load on the heart muscle and blood vessels. Action of this kind is not the same in different situations.

Depends on the specific drug. Thus, potassium-sparing medications are relatively mild, and therefore do not provoke large urine output at one time, which allows you to adjust the tonometer readings slowly and carefully.

Osmotic agents or loop diuretics “reduce” blood pressure levels in a matter of minutes, which can be extremely risky and can provoke dangerous complications.

Such points are taken into account without fail, because the prospects for using a particular medication in a particular case depend on the effect and its severity.

Strictly speaking, diuretics for blood pressure are not specific drugs; they are used as auxiliary drugs in short courses or in emergency conditions, such as a hypertensive crisis.

And then with great caution. A sharp drop in blood pressure is just as dangerous as an increase.

Diuretic herbs for hypertension

When blood pressure rises occasionally, but there are cases of swelling of the extremities, it is recommended to use diuretic herbs.

If the tonometer shows pressure ≥ 150/90, consultation with a cardiologist is required.

Effective herbs that remove salt and fluid from orgasm:

• Milk thistle is a good diuretic for reducing blood pressure in humans. It has a strong diuretic property and is used both as an independent and additional remedy in the treatment of hypertension, kidney and heart disease. Decoctions based on it are recommended to be used in small doses. In addition to normalizing blood pressure, the herb cleanses the body of harmful toxins.
• Yarrow - has antihypertensive, anti-inflammatory and anti-edematous effects. Reduces pain and muscle cramps, reduces swelling.
• Bearberry is a diuretic herb with diuretic properties. Used in short courses.
• Thyme. Often used in the treatment of hypertension, as a sedative and diuretic.
• Rose hip. It has been proven that rosehip tinctures and decoctions remove unnecessary fluid and salts with urine.
• Melissa. An effective remedy for diseases of the cardiovascular system.

For decongestant decoctions they also use: linden, lingonberry leaves, oregano, calendula, hemlock, viburnum, coltsfoot.

Antihypertensive mixtures include: St. John's wort, sage, birch buds, flax seeds, nettle, rowan, elderberry.

Benefits of using diuretic herbs for blood pressure:

1. Gently normalize indicators of the cardiovascular system;
2. Reduces both arterial and intracranial pressure.
3. There is no application dependency;
4. Minimum side effects on internal organs;
5. Have a beneficial and therapeutic effect on other parts of the body;
6. After consultation with a doctor, they can be taken simultaneously with hypertension pills, reducing the dose of medication.

It is not recommended to independently prescribe doses and regimens for taking diuretic herbs. You need to take a prescription from your doctor or specialized herbalist.

Classification

Typing is carried out according to the pharmaceutical group of the drug. Accordingly, four types of medications can be distinguished.

Potassium-sparing

Diuretics that do not remove potassium are mild-acting medications, which determines the preference of doctors in the treatment of relatively mild forms of hypertension (grade 1).

As follows from the general name of the group, they do not provoke an aggressive decrease in the filtering function of the kidneys, they work selectively and affect only part of the physiological mechanism. Therefore, it is possible to preserve potassium, which is vital for adequate functioning of the heart muscle and blood vessels.

At the same time, prolonged use affects the condition of the kidneys and cardiac structures in an identical, negative way. Medicines are absolutely not suitable for constant and especially uncontrolled use.

The issue should always be resolved at the discretion of the treating specialist.

Amiloride

It is considered one of the most modern drugs in the group of potassium-sparing diuretics. It makes sense to prescribe it for relatively mild forms of hypertension or symptomatic increase in blood pressure.

As clinical practice shows, the effect of Amiloride occurs gradually, over a period of several hours.

There is no critical decrease in the filtering function, and therefore the release of large amounts of urine, which makes it a mild and safe medicine.

At the same time, when taken systematically, there is a stable decrease in tonometer readings, which is considered the desired result of therapy.

It makes sense to prescribe Amiloride to patients, including those with minor renal impairment, if the effect that doctors assume exceeds the likely risks. This is a general rule for the use of drugs with a diuretic effect.

Spironolactone

Another classic long-acting medication. The duration of the beneficial effect distinguishes it from others, therefore, when prescribing systematic treatment, rare use is recommended, often 1 tablet per day is enough.

The product is available in several trade names. The one mentioned is not the most popular. Most patients know the tablets as Veroshpiron. The fundamental difference is only in the manufacturer.

There are domestic and imported analogues. There is no consensus on what is more effective. It is assumed that foreign names are “cleaner”, therefore they work faster and provoke fewer side effects, and also less often. There is no exact data on this yet.

Spironolactone is a mild diuretic that is prescribed to eliminate hypertension at stages 1-2, but only as part of systemic, complex therapy. Not in isolation, because there will be no beneficial effect.

Triamterene

It closes the top three drugs that are most often prescribed by cardiologists and related specialists.

It is not fundamentally different from previous names. Therefore, the question of choice relates rather to the problem of individual effectiveness and safety.

If one name is intolerable, another is used. They are interchangeable. Like other potassium-sparing agents, Triametren has a prolonged action. The effect is achieved after a few hours and lasts for half a day.

The medicine is ideal for course use, because it has a minimum of contraindications and side effects.

Diuretics for high blood pressure

Diuretics are often recommended as a means of reducing high blood pressure. Adequate intake of them reduces swelling, improves heartbeat and normalizes blood pressure.

All diuretic drugs are divided into independent classes:

There is another class of diuretics called carbonic anhydrase inhibitors. Due to the fact that it is not used as an independent medicine, it is used very rarely. For example, it is used for a combination of hypertension and glaucoma.

Thiazide and thiazide-like

Moderate diuretics. Unlike their “brothers,” they do not retain potassium ions in the patient’s body as effectively, which is why they are almost never used for long-term use.

It is worth prescribing thiazide diuretics for the initial and middle stages of hypertension and symptomatic increase in blood pressure.

With a pronounced process, the effectiveness is minimal. In such a situation, it makes sense to take moderate diuretics only as part of complex combination therapy.

Dichlorothiazide

Key name within the pharmacological group under consideration. It is prescribed in the amount of one tablet per day, but it is possible to increase the dosage, depending on the situation.

Attention:

It is worth prescribing Dichlorothiazide in combination with ACE inhibitors and beta blockers. The manufacturer himself points to this.

Despite its less suitability for long-term use, the maximum effect is achieved after almost a month, making the average course at least 4-8 weeks.

The issue of duration and dosage should be carefully monitored by the treating cardiologist. If necessary, the volume of application is reduced or increased.

Laboratory parameters, primarily urine, are also assessed without fail. Because induced renal filtration disorders are possible.

Hypothiazide

Comparative old pharmaceutical. There is no fundamental difference between it and the previous name. These are complete analogues. The base contains an identical substance.

The difference lies in the concentration of the active component. What exactly to prescribe in such a situation does not play a big role. Hypothiazide - inexpensive diuretic tablets (cost from 80 rubles).

Indapamide

Belongs to the group of thiazide-like sulfonamines and has a moderate diuretic effect. The medicine reduces the tone of the smooth muscles of the arteries and has a vasodilator effect.

Indapamide helps reduce left ventricular hypertrophy. It has an antihypertensive effect in doses that do not have a pronounced diuretic effect.

The therapeutic effect develops after 7-14 days, reaches a maximum at 8-12 weeks and lasts up to 8 weeks. After a single dose, maximum effect is observed after 24 hours.

Recommended schemes

Diuretics are initially included in the treatment regimen for hypertension, regardless of the stage of the disease. The lack of the desired result may be due to incorrect selection or insufficient strength of influence, or incorrect dose. The doctor will select medications empirically, so it is important to inform him of all symptoms and monitor blood pressure readings.

What drugs enhance the diuretic effect?

There are a number of drugs that enhance the diuretic effect. Thus, the effect of thiazides can be enhanced by ACE inhibitors and calcium channel blockers. This regimen is the standard of care.

It is important to remember that diuretics are prescribed to patients with diabetes mellitus with extreme caution: not the most powerful drugs are selected in small doses or are completely replaced with other drugs; in some cases, it is advisable to take only ACE inhibitors. This is associated with a high risk of leaching of useful substances. Otherwise, there is a possibility of complications developing:

● arrhythmia; ● dehydration; ● loss of orientation in space and neurological disorders; ● skin rash; ● changes in muscle tone and involuntary muscle contractions; ● nausea, vomiting, increased sweating, etc.

Elderly patients often use drugs such as Amlodipine, Indapamide, etc. Strict adherence to the doctor's recommendations regarding dosage will prevent imbalances in fats and carbohydrates and the development of complications.

Diuretics are contraindicated in pregnancy, gouty arthritis, impaired glucose absorption and metabolic syndrome.

Diuretics are not a way to completely cure hypertension. They work effectively in combination with other drugs. They help reduce fluid volume, which means blood volume, and ease the load on blood vessels. As a result, they help prevent heart failure.

Modern diuretics are drugs such as Lasix, Diacard, Hydrochlorothiazide, Triamterene, etc. They can be prescribed even with a high risk of hypertensive crisis. Your doctor may recommend a combination of a modern diuretic with Indapamide or Perindole. Such drugs enhance the therapeutic effect of each other and prevent complications on the urinary system, in particular the kidneys.

Osmotic

Powerful medications. The main one is Mannitol.

It is considered an urgent medicine. It causes a rapid and pronounced effect, removes a huge amount of fluid from the body, therefore a precise dosage regimen is required.

Attention:

If used incorrectly, dangerous complications can occur, including death.

Also, medications from the group of osmotic diuretics are extremely demanding in terms of dosage selection and consideration of contraindications.

For obvious reasons, the names of this group are not used in “domestic”, home conditions. These are too strong drugs.

The classic destination for Mannitol and its analogues is in the hospital, for the rapid restoration of cardiac function and normalization of blood pressure.

That is, these are emergency medications. In other situations, it is not recommended to use them; the risks are too great.

Loop

Unlike medications that do not remove potassium, these are strong diuretics; at high blood pressure they act harshly, provoke a rapid effect, and remove large amounts of fluid from the body. Therefore they are not suitable for long-term use.

They are used to relieve dangerous conditions, including at home, as prescribed by the treating specialist and with his permission.

But unlike the same osmotic diuretics, their effect is still much milder, which allows doctors to resort to prescribing them more often and with less risk. They are not suitable for long-term use.

Diuver

A medication based on torasemide. Has a rapid effect. The beneficial effect is achieved after 5-10 minutes, rarely more.

The required concentration of the drug must be strictly observed to avoid dangerous complications.

Suitable for relieving hypertensive crisis and treating arterial hypertension with persistent increase in blood pressure.

Of course, you cannot use the product constantly. How to drink it correctly - you need to check with your doctor. Any deviations in health are grounds for re-examination.

Furosemide

Prescribed for the treatment of a group of disorders. Both a persistent increase in indicators for hypertension, and against the background of heart failure, swelling with such and as a symptom of other pathologies. Lasix is ​​another trade name for Furosemide.

It is considered the most popular medication among loop diuretics. Many people unreasonably use Furosemide to normalize body weight and take it systematically.

This is a grave mistake that will cost your health, and possibly your life. Illiterate use provokes kidney failure. Diuretics are not suitable for weight correction under any circumstances.

Diuretics should be taken with caution

Diuretics are prescribed by a doctor after examination. Such drugs are recommended only for a limited group of patients. For example, those experiencing problems with arterial hypertension, kidney disease, edema and heart failure.

In addition to their beneficial properties of removing harmful substances from the body, diuretics can displace vital minerals and vitamins.

Self-medication can lead to a person developing health problems.

Long-term use most often results in:

1. Kidney failure;
2. Joint pain;
3. Bone problems;
4. Muscle cramps.

If the drug was prescribed by your doctor, you must strictly adhere to its dosage.

Mixed or combined

They are used relatively rarely, because it is difficult to control the dosage and the effectiveness of the therapeutic course. The reason is the complex composition.

A list of names is presented on the pharmaceutical market: Isobar, Dyazid and others. If the doctor considers it appropriate to use combination drugs, then you should start with the minimum dosage.

When using a large volume once, there is a high risk of a rapid beneficial effect. It may be dangerous. In addition, the likelihood of developing emergency conditions and side effects is also much higher.

As a rule, doctors resort to using combined names if the previous ones are not suitable due to low efficiency. This is a rare situation, and the problem is usually not with diuretics, but with incorrectly selected primary therapy.

Diuretic tablets for high blood pressure are prescribed based on the severity of the condition, blood pressure indicators, and parallel current diseases. Therefore, there is no point in using it independently.

It is impossible to achieve a high-quality effect without risks without conducting a thorough analysis of your own situation.

Folk remedies for hypertension

In case of allergies to chemicals, doctors advise using safe dietary supplements with a diuretic effect. You can use tinctures, teas, juices, decoctions.

To combat high blood pressure, it is recommended to add cranberries, parsley, dill, oats, and raw beets to your diet.

A normal pulse and excellent blood pressure readings are diagnosed in people who drink courses of tinctures and decoctions with:

• Lingonberries, chokeberries and cranberries;
• Bearberry and burdock roots;
• Hawthorn and juniper;
• Motherwort and valerian.

It is important to understand that this only helps against high blood pressure caused by stress, physical activity, fatigue at work or insomnia. If a diagnosis of hypertension is made, it requires drug treatment under the supervision of a general practitioner.

Indications for use

The reasons for using diuretics vary. A lot of points are taken into account. It is better to clarify the complete list in the annotation.

If you look at the average picture:

• Heart failure. Acute or chronic. The rapid removal of fluid from the body will allow you to adjust the load on the cardiac structures, therefore the likelihood of a negative outcome and progression of the disease is several times lower. The measure is temporary, but nevertheless effective.
• Arterial hypertension. At any stage, but with a caveat: depending on the course of the violation and its severity, the stage of deviation, the name and group will be different. The issue is resolved by the treating specialist.
• Edema due to kidney problems and heart pathologies. For one-time normalization of the condition.
• Diabetes insipidus. Has nothing to do with similar pathology. In this case, it is not the pancreas that is involved, but the pituitary gland and hypothalamus or the kidneys.

The problem is the low production of vasopressin, a special hormone that reduces the release of fluid from the body.

In the first case, this is a neurogenic and at the same time endocrinological problem. In the second, there is a decrease in the sensitivity of the kidneys themselves to this compound. It is in this situation that diuretics may be useful.

• Liver pathologies in which there is stagnation of fluid in the abdominal cavity. The so-called ascites.

The list is incomplete. It is better to check the exact details in the instructions.

Contraindications

Among these are:

• Childhood. Not always, but the most “heavy” drugs are not used in patients under 18 years of age. However, not in all cases. The same Furosemide is not used up to 3 liters, the question is individual.
• Pregnancy and breastfeeding period. Identically.
• Acute glomerulonephritis. Autoimmune inflammation of kidney tissue with the development of destruction.
• Hepatic coma.
• Heart failure with a critical drop in the amount of urine output. Until the filtering function is normalized. In this case, doctors have to solve a whole range of problems.
• Heart and vascular defects: mitral, aortic stenosis and some others.
• Individual intolerance to the components of the product. Allergic reactions to drug components. They are determined during the admission process. If there is a problem, it makes sense to replace the drug with another one that has a similar pharmacological effect.

Depending on the individual characteristics of the body, unaccounted for moments are also possible. Therefore, it is recommended to carefully monitor your own feelings. If necessary, consult your doctor again to review the course of therapy or adjust the dosage.

Side effects

Without exception, all diuretics can potentially provoke a lot of disorders. However, as practice shows, in most cases everything is limited to the following points:

• Headache. Neurological manifestations, such as nausea, inability to normally orient in space.
• Orthostatic hypotension. When you change your body position, your heart rhythm is disrupted and your vision becomes dark. The result of a sharp drop in blood pressure.
• Tachycardia. An increase in the number of contractions of a muscle organ per minute. Over 90.
• Abdominal pain, diarrhea, constipation. Stool disorders.
• Indigestion, dyspepsia. Including belching, flatulence and other similar ones.

The instructions describe many more adverse events. In fact, the list is minimal.

Often those that are present disappear on their own after some time. If you are intolerant, you should consult a doctor to review your therapy.