A recent study by Columbia University has found that one of the most commonly prescribed drugs for high blood pressure, called ACE inhibitors, may not be the best choice for many patients.
The study suggests that another type of medication, thiazide diuretics, is more effective in reducing the risk of serious heart problems and causes fewer side effects. Surprisingly, despite this, thiazide diuretics are prescribed far less often than ACE inhibitors.
When doctors treat high blood pressure, they have a range of medications to choose from. These include thiazide diuretics, ACE inhibitors, angiotensin II receptor blockers (ARBs), and calcium channel blockers, among others.
However, there is not much solid data to guide doctors on which drug is the best to start with. Because of this, many current medical guidelines rely on expert opinions rather than large-scale studies.
In this new study, researchers analyzed health data from about 5 million patients who had just started taking medication for high blood pressure. Their goal was to find out which treatment had the best outcomes for patients.
They discovered that nearly half of the patients, around 48%, were first prescribed ACE inhibitors. In comparison, only 17% of patients started with thiazide diuretics, even though this drug class showed better results.
The study’s findings were striking. Patients who began their treatment with thiazide diuretics experienced 15% fewer heart attacks, strokes, and heart failure than those who started with ACE inhibitors.
Thiazide users also had fewer side effects compared to those on ACE inhibitors. In fact, patients treated with ACE inhibitors had higher rates of 19 different side effects, ranging from kidney issues to persistent coughs.
The researchers pointed out that if the patients in the study had started with thiazide diuretics instead of ACE inhibitors, around 3,100 major heart-related events, such as heart attacks, could have been avoided.
This highlights the importance of reconsidering which drugs are prescribed first for high blood pressure.
Thiazide diuretics are already a well-known treatment for high blood pressure and have been used for decades. They work by helping the kidneys remove excess salt and water from the body, which lowers blood pressure.
On the other hand, ACE inhibitors work by relaxing blood vessels, making it easier for the heart to pump blood. Both medications are effective, but this new research shows that thiazide diuretics may be a safer and more effective first choice for many patients.
This study challenges the current practices of prescribing ACE inhibitors as the go-to treatment and suggests that doctors should consider thiazide diuretics more often when deciding on a first-line therapy for high blood pressure.
Given the potential to prevent serious health issues and reduce side effects, this research could influence future guidelines for treating high blood pressure.
The study was led by George Hripcsak and his team and was published in The Lancet. It emphasizes the need for doctors to base their decisions on the best available data, ensuring that patients receive the most effective and safest treatment for their condition.
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