A new study from Columbia University suggests that one of the most common drugs used to treat high blood pressure—ACE inhibitors—might not be the best choice for many people.
Instead, another group of medicines called thiazide diuretics may work better and cause fewer side effects.
The study, published in the journal The Lancet, looked at health records from about 5 million people who had just started treatment for high blood pressure. The goal was to figure out which medicine helped patients the most.
Doctors can choose from several types of blood pressure drugs, including ACE inhibitors, thiazide diuretics, angiotensin II receptor blockers (ARBs), and calcium channel blockers.
But there isn’t a lot of strong evidence showing which should be used first. Current guidelines mostly rely on expert opinions, which means doctors often make different choices.
In this study, researchers found that almost half of the patients—48%—were first given ACE inhibitors. Only 17% started with thiazide diuretics, even though these drugs gave better results.
People who took thiazide diuretics had a 15% lower risk of having serious heart problems like heart attacks, strokes, or heart failure compared to those who took ACE inhibitors. They also had fewer side effects.
In fact, patients on ACE inhibitors were more likely to experience 19 different health issues, including kidney problems and a dry cough. These are known side effects of ACE inhibitors.
The researchers estimated that if everyone in the study had taken thiazide diuretics instead of ACE inhibitors, about 3,100 major heart-related problems could have been avoided.
This finding could change the way doctors think about treating high blood pressure. Thiazide diuretics have been used safely for many years. They work by helping the kidneys get rid of extra salt and water, which lowers blood pressure.
ACE inhibitors work differently. They help relax blood vessels so that the heart doesn’t have to work as hard. Both types of medicine can be effective, but this new research suggests thiazide diuretics may be a better first choice for many patients.
Dr. George Hripcsak, the lead researcher, said doctors should rely more on real data when choosing medications. If thiazide diuretics can help more people and cause fewer problems, they should be used more often.
These results may influence future medical guidelines. By rethinking which drugs to use first, doctors could help patients avoid serious health issues and feel better overall.
For people with high blood pressure, this means there might be safer and more effective treatment options available. It’s always a good idea to talk with your doctor about the best medicine for your needs.
If you care about high blood pressure, please read studies about breakfast for better blood pressure management, and the gut feeling that lowers blood pressure.
For more health information, please see recent studies about how the dash diet helps lower blood pressure, and how to eat your way to healthy blood pressure.
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