High blood pressure, also known as hypertension, is a serious health condition that affects millions of people around the world. If it’s not treated properly, it can lead to dangerous problems like heart attacks and strokes.
Doctors have several types of medicines they can use to treat high blood pressure, but there’s been ongoing debate about which medicine is the best one to start with.
There are five main types of medications commonly used for high blood pressure. These are ACE inhibitors, thiazide diuretics, calcium channel blockers, beta-blockers, and angiotensin II receptor blockers (ARBs).
While all of them can lower blood pressure, it hasn’t been very clear which one is the safest and most effective to use first. Because of this, many doctors decide based on their own experience or habits rather than solid evidence.
A research team at Columbia University wanted to better understand which medication works best as a starting treatment. They focused their study on two of the most widely used types: ACE inhibitors, which are the most commonly prescribed, and thiazide diuretics, which are used much less often.
To get a clearer picture, the researchers studied the health records of almost 5 million people who had just started taking medication for high blood pressure. Around half of them had been prescribed ACE inhibitors as their first treatment, while only 17% had started with thiazide diuretics.
The results were surprising. The study found that patients who began treatment with thiazide diuretics had better outcomes than those who started with ACE inhibitors. In fact, people on thiazide diuretics had 15% fewer major heart problems, such as heart attacks and strokes. On top of that, they also experienced fewer side effects compared to those on ACE inhibitors.
The researchers went on to estimate that if all the patients who had started on ACE inhibitors had instead taken thiazide diuretics, about 3,100 serious heart-related events could have been avoided. This raises an important question—why are ACE inhibitors prescribed so much more often if thiazide diuretics might be safer and more effective?
One reason may be habit. Since ACE inhibitors have been popular for many years, doctors may continue to use them simply because that’s what they’re used to. Another reason could be concerns about thiazide diuretics, such as the risk of low potassium levels or their effect on blood sugar, though the study found that overall, they caused fewer problems.
It’s also important to remember that every person is different. The best treatment can depend on many factors, including other health issues, age, lifestyle, and how the body responds to certain medications. What works well for one person might not work as well for another.
Even so, this study suggests that thiazide diuretics deserve more attention and should perhaps be considered more often as the first medicine to treat high blood pressure.
The research was published in The Lancet, a respected medical journal, and the authors made it clear that more studies are needed to confirm their findings and to better understand why thiazide diuretics seem to work so well.
In the end, this research shows that medical treatment is always evolving. New evidence can change the way we think about common health problems. For doctors, it means keeping up with the latest research. For patients, it means having open conversations with their healthcare providers about the best treatment options.
Managing high blood pressure is important for staying healthy, and choosing the right starting medicine could make a big difference in preventing serious heart problems in the future.
If you care about high blood pressure, please read studies that early time-restricted eating could help improve blood pressure, and natural coconut sugar could help reduce blood pressure and artery stiffness.
For more information about blood pressure, please see recent studies about How to eat your way to healthy blood pressure and results showing that Modified traditional Chinese cuisine can lower blood pressure.
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