ABSTRACT
This chapter reviews the various classes of drugs, and how they work and their side effects. Diuretics are often referred to as “water pills”. Diuretics are used as monotherapy to treat mild-to-moderate hypertension or as an adjunct to other antihypertensive agents. The central alpha-agonists all stimulate a central receptor in the brain stem, which reduces sympathetic nervous system activity to the body that lowers epinephrine and norepinephrine. The direct vasodilators have a potent relaxation effect on the vascular smooth muscle of arteries, reducing arterial constriction, which lowers blood pressure by the vasodilation. Indapamide is the preferred diuretic, and chlorthalidone would be the second. Various and rational combinations are used depending on the severity of the blood pressure and other clinical indications. The side effects of all of these medications is low, and the cost is reasonable and usually covered by most insurance companies. The doctor will monitor various labs when prescribing these drugs.
