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What is the Connection Between Lisinopril and Hydrochlorothiazide?

By Dale Marshall
Updated May 17, 2024
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Generally prescribed in cases of high blood pressure, lisinopril and hydrochlorothiazide form an effective combination to lower a patient’s blood pressure. Lisinopril is a medication commonly prescribed to control blood pressure, and hydrochlorothiazide is a diuretic, or “water pill,” prescribed to induce urination.

High blood pressure, or hypertension, is often called a silent killer because there are no outward symptoms. However, the condition places a burden on the heart and the entire circulatory system, and can lead to impaired circulatory function, stroke, heart attack and/or kidney failure. Monitoring blood pressure is thus an important component of proper health care, and if it exceeds normal parameters, steps should be taken to bring it down. Medical professionals, when encountering hypertension in their patients, often prescribe a combination of lisinopril and hydrochlorothiazide. Two primary areas in which blood pressure can be affected are the flexibility and elasticity of the veins and arteries, and the volume of blood in the circulatory system. Lisinopril and hydrochlorothiazide together target both of these areas, and are so popular in combination that in certain dosages they're contained in the same tablet.

Lisinopril is an angiotensin converting enzyme inhibitor, or ACE inhibitor, which works by stopping the production of a protein called angiotensin II, which contributes to raising blood pressure primarily by tightening the walls of veins and arteries, reducing the volume of blood the system can comfortably contain. By inhibiting production of angiotensin II, lisinopril effectively increases the elasticity of the venal and arterial walls, increasing the volume of blood in the body, thus decreasing the blood pressure.

Developed in the latter half of the 20th century and becoming generally available to patients in the early 1990s, lisinopril is an inexpensive and very effective hypertension medication for many patients. Taken orally, it lasts long enough in the system so that only a single daily dosage is required, which facilitates patient compliance. Lisinopril is also prescribed for patients with congestive heart failure and/or previous heart attacks, as well as to prevent renal and retinal complications of diabetes.

While lisinopril fights hypertension by preventing the tightening of artery and vein walls, hydrochlorothiazide works to reduce the volume of liquid and salts in the bloodstream, thus also reducing blood pressure. Specifically, hydrochlorothiazide inhibits the ability of the kidneys to retain liquid, which in turn reduces the volume of blood in the circulatory system, resulting in decreased blood pressure. Hydrochlorothiazide is also prescribed congestive heart failure, the prevention of kidney stones and symptomatic edema, as well as for nephrogenic diabetes insipidus. Another use of hydrochlorothiazide is the control of osteoporosis by promoting the kidneys’ retention of calcium.

Lisinopril and hydrochlorothiazide work well together because they’re complementary in their effects: lisinopril’s effect is essentially mechanical, affecting the circulatory system’s ability to contain the volume of blood by relaxing the venal and arterial walls, and hydrochlorothiazide’s effect is actually to reduce the volume of liquid in the system.

Like all prescription medications, both lisinopril and hydrochlorothiazide have a disquieting list of potential side effects, but in fact the incidence of side effects is relatively rare, and most patients report no problems.

WiseGeek is dedicated to providing accurate and trustworthy information. We carefully select reputable sources and employ a rigorous fact-checking process to maintain the highest standards. To learn more about our commitment to accuracy, read our editorial process.

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