Science of blood pressure meds - do they work in the long term?

I've been on calcium channel blockers for over a month. Although there was an initial dip in BP, I'm currently at my typical BP values. I've had the same experience with ACE inhibitors. In the past I've also tried diet and exercise (without meds), and this visibly improved my readings. Reading... show more I've been on calcium channel blockers for over a month. Although there was an initial dip in BP, I'm currently at my typical BP values. I've had the same experience with ACE inhibitors.

In the past I've also tried diet and exercise (without meds), and this visibly improved my readings.

Reading some answers here, I've seen some medics state that their patients "refused to diet/exercise and therefore their BP meds didn't work". That sounds to me as though those meds are hardly more effective than a placebo.

I understand how diuretics work in the short term (urinate, get rid of fluids, pressure goes down) but don't see how they would be effective in the long term (drink water, replenish fluids, pressure goes back up).

Likewise, I can't see how calcium channel blockers work (vessels dilate, pressure drops; drink water, extra "space" in vessels gets filled up with more blood plasma, pressure goes back up).

This seems to match with what I've observed in my own BP logs when taking the meds.

I can see beta blockers could work in the long term, but as of yet I'm not willing to deal with the side effects described. In fact, as things are right now, I've got a few symptoms which are known side effect of the meds I'm currently taking, and it's interfering with my job.

My questions are:

1. Although it's great that BP meds can temporarily dip my BP to a lower point, which is great for emergencies, do meds which dilate the vessels and/or diuretics *actually* work in the LONG term? Explain how? Insights are appreciated.

2. I'd like to use my BP logs for some halfway solid science. How can I prove to a degree of certainty whether the meds I'm currently taking work significantly better or worse than diet and exercise? (My statistics skills are very, very rusty)

3. Despite their best intentions to serve my well-being, the pharmaceutical industry has a financial motive as well. I don't mean to sound like a conspiracy theorist, but how can I be sure that my well-being and quality-of-life are put BEFORE their financial interests? Apart from muscle aches, the "side effects" of exercise would be mostly positive (better looks, more energy... I can live with that!) contrary to the side effects of meds.

(4. Mr. "It's common sense", don't bother answering with your spam. I drink enough water as is.)
Update: Followup question - http://answers.yahoo.com/question/index;...
5 answers 5