A recent study from Columbia University has raised questions about current guidelines for treating high blood pressure.
The researchers found that chlorthalidone, a commonly prescribed diuretic for lowering blood pressure, causes more serious side effects than hydrochlorothiazide, another widely used diuretic.
While both medications are similarly effective at reducing blood pressure and preventing heart-related problems, chlorthalidone appears to come with significantly higher risks.
The study analyzed 17 years of health records from over 730,000 people being treated for high blood pressure. Both drugs were found to be equally effective in preventing major cardiovascular events, such as heart attacks, strokes, and hospitalizations for heart failure.
However, patients taking chlorthalidone were much more likely to experience side effects related to electrolyte imbalances and kidney function.
One key finding was that patients on chlorthalidone had nearly three times the risk of developing hypokalemia, a condition where blood potassium levels drop too low. Low potassium can lead to abnormal heart rhythms and other serious complications.
In the study, 6.3% of patients on chlorthalidone developed hypokalemia, compared to only 1.9% of those on hydrochlorothiazide. Even at lower doses, chlorthalidone was associated with higher rates of this condition.
Other side effects linked to chlorthalidone included low sodium levels (hyponatremia), which can cause confusion and increase the risk of kidney failure, as well as a greater likelihood of type 2 diabetes.
These risks highlight the importance of carefully monitoring patients who take chlorthalidone, particularly for electrolyte imbalances and kidney problems.
The findings challenge current treatment guidelines, which recommend chlorthalidone over hydrochlorothiazide for lowering blood pressure.
This preference is largely based on earlier studies suggesting that chlorthalidone has longer-lasting effects on blood pressure. However, the new data suggest that the risks of side effects may outweigh any benefits in many cases.
This is not the first time concerns have been raised about chlorthalidone. Previous observational studies also reported that it is more likely to cause electrolyte imbalances than hydrochlorothiazide.
Given these findings, some experts are calling for updated guidelines that better account for the potential risks of chlorthalidone.
For patients already taking chlorthalidone, the study’s authors recommend regular monitoring for side effects, including blood tests to check potassium and sodium levels.
If you are concerned about your medication, it’s important to discuss options with your doctor rather than stopping treatment on your own.
High blood pressure is a major risk factor for heart disease, stroke, and kidney failure. While medications are an important part of treatment, lifestyle changes such as improving diet, exercising regularly, and managing stress can also help.
New research continues to explore innovative ways to prevent and treat high blood pressure, including studies on the role of certain nutrients and foods in managing the condition.
This study, published in JAMA Internal Medicine and led by George Hripcsak and his team, underscores the need for a balanced approach to choosing blood pressure medications, considering both their benefits and potential side effects.
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