Q. I have enjoyed excellent health all my life, but last year my doctor diagnosed high blood pressure (170/90). He prescribed triamterene/HCTZ and atenolol. I also take vitamins and a half aspirin daily.
The medicine has brought my blood pressure down to around 130/63, but I feel extremely fatigued. My doctor has also informed me that a test shows I’m getting very close to diabetes. I can’t help wondering if my medicine is contributing to the trouble I now face.
A. Your medicines seem to be controlling your blood pressure, but they could be causing your current problems. Atenolol may cause fatigue also known as the “beta blocker blahs” or the “beta blocker blues.” There is also growing reservation among cardiologists in the know about the advisability of relying on beta blockers like atenolol, metoprolol or propranolol as first-line blood pressure medications. British experts in hypertension save beta blockers for the last line of defense, using other kinds of medications first.
Hydrochlorothiazide (HCTZ) is a diuretic that has been associated with elevated blood sugar. This drug may actually tip the balance for some people and bring on diabetes. Such diuretics may also raise uric acid levels high enough to trigger gout.
Here are some other things to be aware of while taking these drugs.
Beta Blocker Side Effects:
• Fatigue, tiredness, blahs, depression
• Dizziness, lightheadedness
• Itchy skin rash
• Difficulty breathing, asthma
• Slow hear rate
• Cold hands or feet
• Nightmares or vivid dreams
• Sensitivity to sunlight, sunburn
• Heart block
• Blood disorders
Triamterene/Hydrochlorothiazide (HCTZ)
• Dizziness
• Imbalance in electrolytes (high potassium levels)
• Muscle cramps, spasms
• Nausea, vomiting, digestive upset
• Elevated uric acid levels, gout
• Sexual difficulties
• Headache
• Visual disturbances
• Skin rash (report to doctor immediately!)
• Sensitivity to sunlight, sunburn
• Irregular heart rhythms
• Anemia
Blood pressure control is essential, but you need to ask your doctor if some other medications would be appropriate. There are many options for lowering blood pressure, and some are less likely to cause the side effects you are experiencing. We have a comprehensive chapter on problems with beta blocker blood pressure pills and discuss many alternative medications as well as non-drug treatments for hypertension in our book, Best Choices From The People’s Pharmacy.
You may also find our Guide to Blood Pressure Treatment of value.
Good luck negotiating with your physician about the best way to control hypertension without causing debilitating symptoms.
