When scientists reported last week that diuretics can be better than newer, more expensive drugs for treating high blood pressure, many people may have wondered: Can I get the same effects from herbal products and nonprescription water pills?
The answer is a qualified yes. But a major caveat is that nonprescription products should be considered only if your high blood pressure, or hypertension, is mild to moderate -- and if you take them with supervision from a doctor or trained herbalist.
"This is a serious medical condition. You should not self-treat for this," said Dr. Mary Hardy, head of the integrative medicine group at Cedars-Sinai Medical Center in Los Angeles.
Most evidence for their usefulness is based on anecdotal experience because most herbs haven't undergone the scrutiny of rigorous clinical trials.
For The Record
Los Angeles Times Tuesday December 24, 2002 Home Edition Main News Part A Page 2 National Desk 19 inches; 707 words Type of Material: Correction
Diuretics -- A story on nonprescription diuretic therapies for hypertension, which appeared in Monday's Health section, contained two errors in the listings of prescription diuretics. In the listing of thiazides, a class of diuretic, the story incorrectly named Dyazide as a brand name for hydrochlorothiazide. Dyazide is actually a more complex medication that contains two diuretics: hydrochlorothiazide and triamterene. Also, the loop diuretic known commercially as Lasix is not fursemide, as the story stated, but furosemide.
For The Record
Los Angeles Times Monday December 30, 2002 Home Edition Health Part F Page 6 Features Desk 4 inches; 177 words Type of Material: Correction
Diuretics -- A story last week on nonprescription diuretic therapies for hypertension contained two errors in the listings of prescription diuretics. In the listing of thiazides, a class of diuretic, the story incorrectly named Dyazide as a brand name for hydrochlorothiazide. Dyazide is actually a more complex medication that contains two diurectics: hydrochlorothiazide and triamterene. Also, the loop diuretic known commercially as Lasix is not fursemide, as the story stated, but furosemide.
"There's no good clinical research that I've seen for blood-pressure treatment with herbs," said Hardy, who routinely recommends herbal diuretics for swelling in the legs and premenstrual syndrome.
Trained herbalists and alternative-medicine practitioners use them as part of a comprehensive treatment plan for hypertension, which includes dietary changes, stress management and exercise, Hardy said. "Herbs are not a magic bullet. They don't replace drugs. They ... work best in the context of lifestyle modifications."
If a patient's blood pressure doesn't go down within two weeks of herbal treatments, it's time to see a physician.
Diuretics help the kidneys get rid of salt and water. By lowering the volume of fluid in the body, they reduce blood pressure. Prescription diuretics used for hypertension include thiazides such as hydrochlorothiazide (Dyazide); loop diuretics like fursemide (Lasix); and potassium-sparing diuretics like spironolactone (Aldactone), which keep the body from losing potassium and causing muscle weakness.
When it comes to herbal alternatives, "the humble and familiar dandelion leaf" is considered equivalent to Lasix as a diuretic, said Amanda McQuade Crawford, a medical herbalist at the Ojai Center for Phytotherapy. Crawford warned against treating hypertension with herbal diuretics from the local health food store or Internet. "Retail products vary too much for the consumer to bank on," she said. She uses extracts made to pharmaceutical standards that are available only to professionals.
Crawford said she also safely treats hypertension with herbal diuretics including the leaf, berry and flower of hawthorn, celery seed and yarrow. But she avoids many herbs advertised as diuretics, such as juniper, which can hurt the kidneys.
The federally sponsored study, which appeared in last week's Journal of the American Medical Assn., compared an inexpensive diuretic, chlorthalidone, with three other classes of hypertension drugs.