A large study from Columbia University has revealed important findings about two popular medicines used to treat high blood pressure: chlorthalidone and hydrochlorothiazide.
The study spanned 17 years and involved over 730,000 people. Both medicines are commonly prescribed to lower blood pressure and help prevent heart attacks, strokes, and hospitalizations due to heart failure.
While both were equally effective in controlling blood pressure, the study found key differences in their safety.
Higher Risk with Chlorthalidone
Patients taking chlorthalidone had a much higher risk of serious side effects compared to those on hydrochlorothiazide. Specifically:
- Low potassium levels (hypokalemia): Chlorthalidone users were nearly three times more likely to develop hypokalemia than those on hydrochlorothiazide. About 6.3% of chlorthalidone users experienced this condition, compared to only 1.9% of hydrochlorothiazide users.
- Electrolyte imbalances and kidney problems: These issues were also more common with chlorthalidone.
Hypokalemia is a dangerous condition that can cause symptoms like abnormal heart rhythms, confusion, and muscle weakness. If left untreated, it can lead to severe complications such as kidney failure or even type 2 diabetes.
Surprisingly, even when chlorthalidone was given in lower doses, the risk of side effects remained higher. This finding has led experts to question its long-standing preference in treatment guidelines.
Why This Matters
High blood pressure is a common condition that can lead to serious health problems if not managed properly. While medication is a key part of treatment, it’s essential to choose the right one. The results of this study highlight the importance of balancing the benefits of a drug with its potential risks.
Doctors prescribing chlorthalidone should closely monitor patients for side effects, especially low potassium levels. For some patients, hydrochlorothiazide might be a safer option.
Managing High Blood Pressure
While medication is important, lifestyle changes are equally critical in managing high blood pressure. Here’s what you can do:
- Healthy diet: Focus on fruits, vegetables, whole grains, and low-sodium foods.
- Exercise regularly: Aim for at least 30 minutes of moderate activity most days of the week.
- Avoid smoking and limit alcohol: These habits can make blood pressure worse.
- Manage stress: Techniques like deep breathing, meditation, or yoga can help.
- Monitor your blood pressure at home: Regular checks can help you and your doctor adjust your treatment plan as needed.
The Bigger Picture
This study, led by George Hripcsak and published in JAMA Internal Medicine, shows how important it is to personalize treatment plans for high blood pressure. Not all medicines are the same, and choosing the right one can make a big difference in avoiding complications.
For patients and healthcare providers alike, the message is clear: Treating high blood pressure isn’t just about lowering numbers—it’s about finding the safest and most effective way to protect your health.
If you care about high blood pressure, please read studies that drinking tea could help lower blood pressure, and early time-restricted eating could help improve blood pressure.
For more health information, please see recent studies about added sugar in your diet linked to higher blood pressure, and results showing vitamin D could improve blood pressure in people with diabetes.
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