Consuelo H. Wilkins, MD
Really. Is it just a water pill?
‘Well why do you think your doctor prescribed it?’, I asked my friend Jordan. ‘My blood pressure was a little high’, she explained. ‘So you have high blood pressure’, I stated. ‘Well, not really. I just take a water pill’, Jordan responded.
This exchange was part of a brief conversation I had with a good friend recently when we were talking about a community health event. Jordan talked about the number of people who had elevated blood pressures at the event and added that her blood pressure was also elevated.
This certainly wasn’t the first time that I’ve heard someone refer to their prescribed diuretic as just a water pill. But Jordan is not the average patient. She is a passionate advocate for quality health care and health literacy and she is very involved in community health programs. So why did she think of her anti-hypertension medication as just a water pill?
Maybe using ‘water’ makes it sound not so bad. If you think that you are taking a pill that just removes a little extra water then maybe your blood pressure isn’t really high or maybe if you drink less water you don’t need to take the pill.
Well all of those are incorrect. Diuretics, commonly referred to as water pills, cause the kidneys to remove sodium and water from the body. The removal of this fluid helps the blood vessel relax and results in a lower blood pressure. Diuretics are often the first line of treatment for high blood pressure. Diuretics may be of particular benefit in treating hypertension in African Americans who are more likely to be ‘salt-sensitive’ (remember, the diuretics remove sodium from the body and salt is sodium chloride).
Diuretics are also prescribed for people with excess fluid accumulations such as with heart failure, kidney problems, and liver failure. Commonly prescribed diuretics are furosemide (Lasix), triamterene, hydrochlorothiazide, spironolactone (Aldactone), and metolazone (Zaroxolyn). Diuretics are also commonly part of a combination pill such as Dyazide, a combination of hydrochlorothiazide and triamterene. If you are prescribed a diuretic (or any medication), ask your doctor what the medication is being prescribed to do.
It is very important that you not stop taking a diuretic without consulting with a physician. Just because you don’t have any outward signs of excess fluid, does not mean that you don’t have excess fluid internally.
People who take diuretics may or may not have increased urination. Medications such as hydrochlorothiazide may cause increased urination for a few days but it usually subsides. Diuretics like Lasix are more commonly used in heart failure and may lead to increased urination long-term.
If you are taking a diuretic, don’t limit your water/fluid intake. If you want to limit your intake of something, limiting your salt intake will be far more helpful than limiting fluids.
So, even though it is a ‘water pill’, it’s not JUST a water pill. Removing sodium and water from your body internally with diuretics for high blood pressure can reduce your risk of heart attack or stroke.