High blood pressure is a common health problem around the world. If left untreated, it can lead to serious issues like heart disease, stroke, or kidney damage. Many people take medicine every day to control their blood pressure, but choosing the best one can be confusing. There are several types of medications available, and doctors often have to decide which is best for each person.
A new study led by RuiJun Chen at Geisinger Medical Center offers helpful insights. The research focused on two common types of blood pressure medications: ACE inhibitors and ARBs. These two types of medicine work in similar ways to lower blood pressure.
They both act on a hormone system in the body that controls how tight or relaxed our blood vessels are. When blood vessels are relaxed and wide, blood can flow more easily, which helps lower blood pressure.
ACE inhibitors, which stand for “angiotensin-converting enzyme” inhibitors, block a chemical that helps produce another substance called angiotensin. Angiotensin is a hormone that tightens blood vessels. By blocking it early in the process, ACE inhibitors help keep the blood vessels open.
ARBs, short for “angiotensin receptor blockers,” work a little differently. Instead of blocking the chemical early, they stop angiotensin from attaching to blood vessel receptors. This also helps the blood vessels stay relaxed and open. In the end, both medicines lower blood pressure, but they do so in slightly different ways.
Currently, ACE inhibitors are more commonly prescribed as the first medicine for people who are just starting treatment for high blood pressure.
However, the Geisinger study looked at medical records and insurance data from nearly 3 million people in the United States, Germany, and South Korea. All of these people were taking blood pressure medicine for the first time and did not have a history of heart disease or stroke.
The study found that both ACE inhibitors and ARBs were equally good at lowering blood pressure. But ARBs had an important advantage: they caused fewer side effects.
Some common side effects from ACE inhibitors include a dry cough, skin rashes, or swelling in certain parts of the body. ARBs are less likely to cause these problems. This means that for many people, especially those who are starting treatment for the first time, ARBs might be a better and more comfortable option.
However, the researchers made it clear that their findings apply only to people starting blood pressure medicine for the first time. If someone is already taking ACE inhibitors or is on several types of medicine, this study does not suggest they should switch.
In 2017, the American Heart Association and the American College of Cardiology recommended four main types of medicine for high blood pressure: thiazide diuretics, ACE inhibitors, ARBs, and calcium channel blockers. All of these have been proven to help prevent serious heart problems when used properly.
But medicine is just one part of managing blood pressure. Doctors also recommend changes to daily habits. This includes eating healthy food, exercising regularly, reducing salt and alcohol, and managing stress. These steps are important whether or not a person takes medication.
This new research helps doctors and patients make better choices about starting blood pressure treatment. While both ACE inhibitors and ARBs are good options, ARBs might be the better first step for many people because they work just as well but may cause fewer problems.
People with high blood pressure should always talk with their doctor before changing any treatment. Staying informed about new research, like this study, can help people better understand their options and feel more confident in their care decisions.
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