Dr. Gott: Experts disagree on blood-pressure strategy

Dear Dr. Gott: Is it necessary to use diuretics to control some instances of high blood pressure, while other patients’ high blood pressures can be controlled with one of the nondiuretics? I am currently taking atenolol, which, I understand, is not a diuretic, although I have been on diuretics in the past.

Both have been successful in keeping my blood pressure at an acceptable level. I believe the type of medication prescribed me changed with a change in doctors: i.e., doctor’s choice rather than my need to make a change.

Why would you not prescribe atenolol?

Dear Reader: Many authorities suggest diuretics (kidney stimulants) as the first round in controlling hypertension. The medicine is relatively inexpensive and safe.

Other experts choose beta-blockers, such as atenolol, as initial therapy. If needed, both drugs can be taken simultaneously.

I prescribe both, depending on the clinical situation (i.e. severity of hypertension, drug allergy and other factors).

Older physicians may prefer this standard approach. Younger doctors may recommend one (or more) of the newer drugs.

The degree of therapeutic success is the prime consideration.

To give you related information, I am sending you copies of my health report “Hypertension” and “Consumer Tips on Medicine.” Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 for each report to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title(s).