A new study from Columbia University has examined two common drugs used to treat high blood pressure: chlorthalidone and hydrochlorothiazide. The study, which took 17 years and included over 730,000 patients, found that while both medications work well to control blood pressure, one of them carries a much higher risk of side effects.
High blood pressure, also known as hypertension, is a major health concern that affects millions of people. If left untreated, it can lead to serious conditions like heart attacks, strokes, and kidney disease. Doctors often prescribe medications to help lower blood pressure and reduce these risks.
Among the most commonly used are chlorthalidone and hydrochlorothiazide. Both belong to a class of drugs called diuretics, which help the body get rid of excess salt and water, making it easier for the heart to pump blood.
For many years, chlorthalidone has been considered the better option because it lowers blood pressure more effectively. However, this new research suggests that it may not be the safest choice. The study found that patients taking chlorthalidone were much more likely to develop serious side effects compared to those taking hydrochlorothiazide.
One major concern is a condition called hypokalemia, which occurs when potassium levels in the blood drop too low. Potassium is an important mineral that helps keep the heart and muscles working properly. When potassium levels fall too much, it can cause irregular heartbeats, muscle weakness, and confusion.
In severe cases, it can even lead to life-threatening complications. According to the study, 6.3% of people taking chlorthalidone developed hypokalemia, compared to only 1.9% of those taking hydrochlorothiazide.
The study also found that chlorthalidone was linked to other problems, including imbalances in important electrolytes like sodium and magnesium, as well as kidney issues.
These complications can lead to kidney failure, increased blood sugar levels, and a higher chance of developing type 2 diabetes. Even when chlorthalidone was given at lower doses, the risks remained high.
Because of these findings, some experts are questioning whether chlorthalidone should continue to be recommended as a first-choice treatment for high blood pressure. While it does a good job of lowering blood pressure, the added risk of serious side effects means that many patients may be better off using hydrochlorothiazide instead.
Managing high blood pressure is about more than just taking medication. Lifestyle changes also play a big role in keeping blood pressure under control.
Eating a healthy diet, exercising regularly, reducing alcohol intake, quitting smoking, and managing stress can all help lower blood pressure naturally. Monitoring blood pressure at home and seeing a doctor regularly are also important steps to stay on top of this condition.
This study, published in JAMA Internal Medicine, highlights the importance of choosing the right medication based on both its benefits and potential risks. While doctors have long relied on chlorthalidone, these new findings suggest that hydrochlorothiazide may be a safer alternative for many patients.
As research continues, healthcare providers will need to consider both effectiveness and safety when prescribing treatments for high blood pressure.
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