This is anecdotal information, based solely on my own experience...

Your symptoms suggest you probably need a potassium supplement, and I
am surprised that your doctor has not checked your level after placing
you on HCTZ.

I have been on Maxzide (combination of Hydrochlorothiazide and
Triamterene) for years.  Even though the Triamterene  is
potassium-sparing (HCTZ is potassium-depleting), I need extra
potassium.  In fact, even with the supplement (I use KCl instead of
salt), my K level was low when I went into the hospital for some
surgery last year.

Chas.

I have used HCTZ for years.  The only problem I've had is that

Hi,

The following should be addressed:

1. Your blood pressure before initiation of HCTZ
2. The dose of HCTZ and any changes
3. Your blood pressure before initiation of Toprol (metoprolol)
4. The dose of metoprolol and any changes in dose
5. Your current blood pressure
6. How long time it took before your pulse went up and if it is still
high
7. Your blood glucose
8. Any other medications you might be on
9. Your serum potassium level and serum magnesium level (the former
should be monitored regularly) (-any leg cramps or muscle weaknesses?)

First of all, the goal of therapy is usually to reduce the blood
pressure (BP) to below 140/90 mmHg. Before initiation of therapy it is
normal to try to acheive this goal by changes in diet (reduce salt
intake). A dose of 25 mg HCTZ daily (in the morning) is usually
sufficient to reduce the BP by 20/10 mmHg and higher doses usually
increase the risk of side effects. Thiazides may result in
hypokalaemia (low potassium) which might lead to hypomagnesia. The
latter may result in heart disturbances. It might be worth to check up
these levels. Initially, thiazides reduce you blood volume (you
probably had to visit the bathroom pretty regularly the first 2-4
weeks?) - however this stabilises after about 4 weeks. This is the
main cause of the BP lowering effect of thiazides. Thiazides may also
activate the renin-angiotensin system which is a response system to
compensate for the BP. Increased heart rate is also a way to
compensate for reduced BP.

Has your heart rate gone down to your regular rythm after initiation
of metoprolol? Is your BP within the target range now?

Wops, I just read about your muscle spasms in your neck. You should
definitely check your potassium level (and magnesium level) - it might
be a clear indication for putting you on potassium supplements. You
could also get potassium from bananas and potatoes (but high intake is
not recommended due to high carbohydrate).

Hope this might help.

Rgds,
Oistein
London