I am a 61 year old male who has been on medication for essential hypertension for over 30 years now. Although I am now overweight, I had HBP when I was 170 lbs and had less than 10% body fat. Most medications don't work well with me. Inderol never had an effect on my BP. Tenormin worked well for about 10-12 years, then stopped having any effect on my BP, though it still lowers my pulse rate. Calcium channel blockers give me edema. ARBs help some, but not enough The biggest problem is that none of those medications even in combination, can get me below about 135/95, without a diuretic. I am very salt sensitive. By going on an extreme salt restriction, I can go with very low doses of medication, and blood work shows normal sodium levels in my blood. But it means never eating out, going to picnics, going to retirement parties etc. I was able to sustain that for about two years on 500-1000 mg a day, but eventually tired of no social life. When I got back to normal sodium levels in food (still never adding salt at home or ever using a salt shaker when out), my BP was higher and harder to control (rebound?). When it was running 160/100 on three medications, I ended up back on the diuretics. I am now on hydralazine, quinapril, atenolol (doc still wants me on it though no effect on BP) and HCTZ. The problem with the HCTZ is I am always tired. I was still a regular at the gym, jogged, and played squash twice a week. On the HCTZ (25mg), I am always tired and cannot do vigorous exercise. As of today, haven't been to the gym in 2 1/2 weeks. When I try to play squash, I start out OK but as the match wears on, I cannot recover between points (catch my breath). Towards the end of matches, I can't run and don't win a point. The lack of activity has led to weight gain which I am sure doesn't help. I am wondering if there is another diuretic which might not have this effect, or if some combination of potassium, magnesium, and calcium supplements would work. I recently had kidney tests, and they are fine. The kidney specialist told me the HCTZ would not make me tired, but I know if I stop it two days before playing squash, I am fine. My PCP is great, but he sent me to the specialist because he wasn't sure what else to do. Maybe I need a new kidney specialist or a specialist in BP for athletes. Hytrin worked years ago but gave me orthostatic hypotension. There must be others who have had similar issues. I tend to get simplistic answers to a complex problem (lose weight, exercise, eat less salt, etc) If it was that easy, I would have done it a long time ago.