It wasn't. Heinlein just *wished* he were that quotable.

-- David Wright

Hello,
I am not a doctor. I had a similar experience with hydrocholorothiazide. It's a diuretic. The electrolytes (eg Potassium, magnesium, sodium) were out of balance which was the reason for your side effects.

You should ask your doctor to prescribe another medication such as Norvasc--a calcium channel blocker--instead of a diuretic.
Jason

Yep, there he goes again, giving medical advice. I think I can say with some confidence that if you ask your doctor to prescribe any specific med, you're going to meet resistance. Clearly, the med you were on was a bad choice for you, and some other approach is indicated, but if your doctor can't figure that out for him- or herself, you need a different doctor.

-- David Wright

COMMENT:

Indeed. Calling HCTZ a "diuretic" is a misnomer, since the diuretic activity is minimal at these doses, and eventually disappears completely. And seems to have little to do with why it lowers blood pressure.

As to potassium problems, 12.5 mg is just about the lower limit of where they appear, but it's possible. Unfortunately, it's also the lower edge of antihypertensive effect, so that's a hard battle to win with monotherapy. And one reason why combinations of HCTZ at this dose, combined with some other potassium-sparing agent like an ACE-inhibitor, are popular and well-studied. The effects of these are synergistic on blood pressure, and antagonistic on potassium. I'm fond of captopril and HCTZ, an old combo, but still a good one. The newer ACE inhibitors have improved on half-life but not on mortality. And the even newer ATB drugs don't have the effect on mortality we expected, either.

Beta blockers have recently come under criticism as first line drugs after the giantic LANCET meta analysis

https://www.webmd.com/content/article/113/110940

but a beta blocker and diuretic was where JNC VI recommended everybody start. That leaves us with the thiazides, but the caveats above apply. Thus, I'm for captopril/HCTZ first. Norvasc (amlodipine) in place of captopril if you cough.

===================================
Blood Press. 1994 Jul;3(4):231-5.

Relation between low dose of hydrochlorothiazide, antihypertensive effect and adverse effects.

Jounela AJ, Lilja M, Lumme J, Morlin C, Hoyem A, Wessel-Aas T, Borrild NJ.

Department of Hypertension Clinic, Deaconess Hospital, Oulu, Finland.

Thiazide diuretics are widely used in the drug treatment of hypertension buttheir dose-response curves for the antihypertensive and adverse metabolic effects differ. To characterize the lower end of the dose-response curve a double-blind, parallel group trial was performed as multicentre study in Scandinavia. One hundred and eleven patients with newly diagnosed or previously treated mild to moderate hypertension (untreated diastolic blood pressure of 95-115 mmHg after 4 weeks placebo) were randomly allocated to various doses of hydrochlorothiazide (3, 6, 12.5 or 25 mg) or placebo for 6 weeks. Blood pressure and biochemical variables (plasma renin activity, serum potassium, magnesium, urate, fasting glucose, total cholesterol, HDL-cholesterol, triglycerides and apolipoproteins A1 and B were measured. 12.5 mg hydrochlorothiazide had a borderline effect on blood pressure whilst 25 mg had a definite antihypertensive effect. Biochemical changes were seen in plasma renin activity, serum potassium and urate after the 12.5 and 25 mg dose. Three and 6 mg had no effect on blood pressure or metabolic parameters.

Publication Types:
Clinical Trial
Multicenter Study
Randomized Controlled Trial

Dr. Wright,
Thanks for providing your advice. If you are not a doctor, you should state in your post: "I am not a doctor" since that it what you advised me to do.
Jason

The difference is that I'm not giving medical advice, and you are.

-- David Wright

Jason, how high was your BP to start with? How long have you been on the med? What are your numbers on the med?

I ask these questions because my naturally inclined Dr is working with me to get my Systolic down without meds. Doing great so far. I have done a bit of research and to be quite honest I'd be afraid to take meds. My body doesn't do well with medications unfortunately.

Although the Dr who posted above stated that the dose was very low, perhaps each body reacts differently to these things?

Hi Belle ~ mind sharing what you are doing to drop your systolic? That's a problem for me personally but we're trying by changing BP meds. I have the diet and exercise part covered so I need other help.

Thanks - Mojo

My Dr wanted to avoid meds if possible. My problem has developed because of leaky heart valves and of course it is gettin worse as I get older (age 60 now). I took the *&$%@! prescription drug almost ten years ago and it did a job on me.

He first put me on a Bonito peptide supplement that took it down about 20 points. I was on that for a few months and then since it wasn't going down further (Systolic started at 188) he put me on a homeopathic supplement that contains magnesium, potassium, hawthrone, Rauolfa and some other herbs. It is called Cardio VH by Empirical Labs. That took it down about another 20 points and I was doing pretty well before we went on vacation Dec/Jan.

It actually got below 140 a few times before we left. Couldn't seem to get it back there when we got back but it was usually under 155. My diastolic is usually around 60-62 and pulse anywhere from 45-60.

After an auto accident March 17th where my chest was badly bruised from the shoulder harness and perhaps the air bag too, my BP has been really scary. It got up to 190/133 and a pulse of 130. Tchycardia...scary...No I didn't go to the ER despite my hubby's worry. I was afraid of being pumped full of drugs and I've learned that my body doesn't do well with them...

I immediately went off my mugs of tea and started a cleansing (www.herbdoc.com). I also added a chelated mineral supplement from Life Zone called Kela Cell Lite after I finished the cleanse. The minerals are specially chelated from Albion labs and yes it does seem to be helping.

I've also been trying to be better about doing my breathing exercises. I use the method from the Oxycise! program. Several days last week my BP actually got to 123/60. I find that if I sit for several minutes then the reading will be less. I will take it three times in a row and invariably the last one is the lowest. I'm too impatient to just sit the 5-8 minutes until I take it.

Of course I messed it all up by having a couple mugs of tea yesterday ...sigh...I seem to be really sensitive to caffeine. I do have some tea extract from Dr. Mercola's web site that isn't too bad...just not the same...sigh...

Wed. I am going to try EFT with the Naturopath that works with my Dr. I'll let you know how it goes. If you don't hear from me by Friday..pm me and remind me.

Sounds like you're doing all you know to do and I wish you good luck. My systolic is not quite as high but the doc wants to get it below 135. Like yourself, I have no problem with the diastolic (mid 50's to mid 60's). Unfortunatley, my heart went into atrial fibrillation this pas weekend so it's impossible to tell much right now. I have to go back to the cardiologist tomorrow morning and I guess get medication to attempt to re-establish a normal sinus rythym and of course begin taking Coumadin to thin the blood down. THis is my second event in three years so all was not a surprise this time around.

Thanks for sharing and I plan to look up the Oxycise method when I'm done here. If I can't find anything I may ask you to fill me in again on that. BP is especially important to me as mine has been elevated since in was 30 years old - almost 65 now. Take care and thanks again.

I was given a prescription for HCTZ after a mtg.
w/mydoc. I became so dizzy after taking it that
I flushed them down the toilet.

I should say that I have a BP machine, purchased
at a local discount store, and my numbers never
reach the ones that occur in the doc's office.
We've discussed this, and I even brought the
device in to him, (It has a memory function)
but I did not bring the cuff. I still tested over the
current standards, but I'm reluctant to just start
taking BP lowering chems based on these seemingly
opposing data.

I'm also wary of the latest, lower standards. At this
time, almost everyone in the world is a candidate
for some kind of BP med.

Sounds like a profit opportunity if I have ever heard one.