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Hypertension is known as the “silent killer” and affects 80 million adults older than 20 years in the US alone.Hydrochlorothiazide or microzide is a diuretic most commonly used for hypertension. Also used for high cardiovascular risk, diabetes and for recurrent stroke prevention.It works by promoting water excreting sodium in the urine decreasing the excess fluid build up in body. Check with your doctor immediately if any of the following side effects occur- Low potassium, sodium and magnesium, Orthostatic hypotension, dizziness, headache, weakness, erectile dysfunction , tingling in your hands, legs, and feet, photosensitivity (a condition where your skin is more sensitive to the sun), muscle spasms, diarrhea, severe skin reactions such as Stevens-Johnson syndrome and exfoliative dermatitis, kidney failure, blurred vision, pancreatitis. Drug interactions and precautions for thiazide diuretics include lithium, digoxin, NSAIDs,epinephrine dofetilide, people with diabetes may have increased blood sugars. dental practitioners should take a detailed family health history and take an Accurate measurement of the blood pressure during dental evaluation and during follow up. The best choice of local anesthetic would mepivicaine without epinephrine. If the Patient feels postural hypotension at the dental office , the patient should be positioned supine with feet elevated and Maintain airway, head tilt-chin lift and administer oxygen if needed. patients taking diuretic drugs are more likely to have xerostomia, dental caries, periodontal disease, and mucosal legions so it’s important to educate patients on the oral implications of the drugs and teach proper oral hygiene.