A recent study by Columbia University has found that one of the most commonly prescribed medications for high blood pressure, ACE inhibitors, may not be the best choice for many patients.
The research suggests that another type of medication, called thiazide diuretics, is actually more effective at reducing the risk of serious heart problems and causes fewer side effects. Despite this, thiazide diuretics are prescribed far less often than ACE inhibitors.
Doctors treating high blood pressure have many medications to choose from, including thiazide diuretics, ACE inhibitors, angiotensin II receptor blockers (ARBs), and calcium channel blockers.
However, there has been limited large-scale data to guide doctors on which medication works best as a first option. As a result, current medical guidelines are often based on expert opinions rather than concrete evidence.
In this new study, researchers analyzed health records from around 5 million patients who had just started taking medication for high blood pressure. Their goal was to identify which treatment led to the best outcomes.
The findings were surprising. Almost half of the patients, about 48%, were prescribed ACE inhibitors as their first treatment. In contrast, only 17% started with thiazide diuretics, even though the results showed that these drugs performed better.
Patients who began treatment with thiazide diuretics experienced 15% fewer heart attacks, strokes, and cases of heart failure compared to those who started with ACE inhibitors.
Thiazide diuretics also caused fewer side effects. In comparison, those treated with ACE inhibitors had a higher risk of 19 different side effects, including kidney problems and a persistent cough.
The researchers estimated that if all the patients in the study had been started on thiazide diuretics instead of ACE inhibitors, around 3,100 major heart-related events, such as heart attacks, could have been avoided.
This is a significant number and highlights the need to reconsider which medications doctors prescribe first.
Thiazide diuretics are not new. They have been used for decades to treat high blood pressure. These medications work by helping the kidneys remove extra salt and water from the body, which reduces blood pressure.
On the other hand, ACE inhibitors relax blood vessels to make it easier for the heart to pump blood. Both drug types are effective, but this study shows that thiazide diuretics may be a safer and more effective first option for many people.
This research challenges the current practice of prescribing ACE inhibitors as the most common first-line treatment for high blood pressure. The results suggest that thiazide diuretics should be considered more often, as they can reduce the risk of serious heart problems and minimize side effects.
The study, led by George Hripcsak and published in The Lancet, emphasizes the importance of using the best available evidence to guide treatment decisions.
By choosing the safest and most effective medication as the first option, doctors can help patients better manage their blood pressure and prevent life-threatening heart problems.
These findings could lead to changes in medical guidelines and encourage healthcare providers to take a closer look at how they treat high blood pressure.
For patients, it serves as a reminder to ask questions about their treatment options and discuss the risks and benefits of different medications with their doctors.
High blood pressure is a major health concern that affects millions of people worldwide. Making informed decisions about the best medications to use can play a key role in improving patient outcomes and preventing serious complications like heart attacks and strokes.
This study offers new insights that could help improve care for people with high blood pressure and ensure they receive the most effective treatment available.
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