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Has Your Doctor Told You?

Updated: Mar 7, 2022

Have you been diagnosed with high blood pressure? If so, chances are you take at least one blood pressure medication.  Do you know what you are taking and how it works? Do you know what else it may be doing to your body?

All too often when I meet a new patient and ask what medications s/he is taking, I get answers like this: “I take a little white pill, a big white pill, a round red pill, a yellow pill…”(they usually know what the little blue pill is though!) or “I don’t know, my wife fills my pillbox” or “I just take what the doctor gave me”

Somehow, I’m always surprised by this. These man-made substances often have significant effects on your body, aside from lowering your blood pressure.  There are many non-pharmaceutical interventions I recommend well before my patients reach the point of needing medicine. These include changes in diet and activity level, quitting smoking, caffeine reduction, weight loss, daily meditation, and reducing sources of stress. However when these goals are set but not accomplished, I do prescribe medication. I am always clear about what patients are taking, how it works, and possible negative effects on the body.  So for those of you who only know the color and shape of your pills,  I will give a very simple explanation of 3 major classes of blood pressure medications, how they work, and what things to watch out for:

1. Diuretics (water pills)–There are different kinds, but some very common ones are hydrochlorothiazide (HCTZ), chlorthalidone, and furosemide. These drugs cause your kidneys to get rid of salt and water. The pressure in your vessels goes down because you are decreasing blood volume.  Your kidneys are very complex organs, however, and interfering with them can cause other problems. These water pills can lower your sodium, potassium, and increase your blood sugar. They can also make gout worse. Be careful guys, these pills are also known to interfere with male sexual function.  Make sure your doctor is checking labs every 6 months to monitor for any changes.

2. Calcium channel blockers–3 common ones are amlodipine, nifedipine, and felodipine. These decrease your blood pressure by dilating your bloods vessels. However, fluid can then shift out of the vessels into surrounding tissue, causing swelling in the feet and ankles. For most people the swelling is mild but for others, it can be intolerable. These meds are also notorious for causing dizziness, headaches, and feeling faint. Usually reducing your dose can help.

3. ACE Inhibitors–These are meds like lisinopril, enalapril, benazapril, etc. They help the body get rid of salt and water and dilate the blood vessels.  Therefore, labs also need to be monitored closely. They reduce the work your heart has to do as well.

Again, this is a very simplified explanation of how these medications work. However for those that take them or have loved ones who do, it is really important that you know what you’re putting into your body. As always, if you have any questions, please feel free to reach out via email.

***Next week, as promised, I will share an interesting patient story with you. Stay tuned!

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