Persistent cough? Tired all the time? Short of breath? It could be your blood pressure medications. Fifty million Americans suffer from high blood pressure and take daily medications to help prevent heart attacks, strokes and heart failure. There are five classes of medicines for lowering blood pressure. They are all effective; but like all good medicines, most have some side effects.

ACE inhibitors are common medicines used to lower blood pressure and are important for patients who have diabetes along with their high blood pressure. They also help decrease the workload on the heart and may prevent heart failure or second heart attacks. ACE inhibitors have some significant side effects that are commonly overlooked. A persistent hacking cough may go on for weeks or months before the culprit is determined to be an ACE inhibitor. The treatment is simply changing the medicine to another class of anti-hypertensive medicine. It may take four to six weeks for the cough to stop, but the results are often dramatic. A second side effect that is not uncommon is swelling of the eyes or lips (angioedema). This swelling is sometimes frightening as well as unattractive. Stopping the medicine will stop the swelling.

Beta blockers are frequently used to control blood pressure and also to help the heart recover after a heart attack. Beta-blockers may cause some undesirable side effects such as fatigue, emotional lability and even shortness of breath. Fatigue is common. The beta-blocker slows the heart rate and makes the patient feel tired and listless. Also, some patients experience depression or anxiety. Others note shortness of breath when they first start exercising because the heart rate stays slow and may not meet the needs of the patient. And some patients find weight gain and increased fat accumulation particularly distressing.

Diuretics such as chlorthalidone or hydrochorthiazide are rapidly becoming the drug of choice in initially treating patients with high blood pressure. These diuretics are both effective and inexpensive. However, they may cause loss of potassium, an essential mineral. When the potassium becomes too low, fatigue, muscle cramps or abnormal heart rhythms can occur.

The bottom line is to know the potential side effects of your medications. Talk with your pharmacist and your doctor, and they will guide you to understanding why your medications may be making you sick!

Dr. Robert Overholt has been in private practice for more than 30 years. He is the host of the television program "The Dr. Bob Show" airing weekly in 13 million homes on the Goodlife Television Network. If you have a question for Dr. Bob, write "The Dr. Bob Show" at 6700 Baum Drive, Suite 1, Knoxville, TN 37919 or send your e-mail to letters@drbobshow.com.