A new study from Columbia University is making doctors take a closer look at which medicines are best for treating high blood pressure.
The research shows that a commonly used drug group called ACE inhibitors might not be the best first choice. Instead, another type of drug—thiazide diuretics—may be safer and more effective.
High blood pressure is often treated with one of five main types of medicines: thiazide diuretics, ACE inhibitors, angiotensin II receptor blockers (ARBs), dihydropyridine calcium channel blockers, and non-dihydropyridine calcium channel blockers.
Doctors usually decide which one to use based on general guidelines. However, these guidelines are often based on expert opinions rather than direct comparisons between the drugs.
In this large study, researchers looked at medical records and insurance data from almost 5 million people who had just started blood pressure treatment. They found that 48% of these people were given ACE inhibitors first, while only 17% started with thiazide diuretics.
The results were surprising. People who took thiazide diuretics first had better outcomes. They were 15% less likely to suffer from major heart problems like heart attacks, heart failure, or strokes compared to those who took ACE inhibitors. That’s a big difference and shows that thiazides might be a better option for many people.
Another important finding was about side effects. People taking ACE inhibitors had more side effects—19 different types in total. These included issues like a long-lasting cough and high potassium levels. People who took thiazides had fewer of these problems, which suggests that thiazides are easier for the body to handle.
The lead researcher, George Hripcsak, and his team estimated that if all the patients who were first given ACE inhibitors had instead started with thiazides, about 3,100 major heart-related problems could have been prevented. That’s a huge number and shows how important the choice of medicine can be.
The study was published in The Lancet, a well-known medical journal. The researchers say that doctors should consider starting more patients on thiazide diuretics instead of ACE inhibitors. With fewer side effects and better results, thiazides might be the smarter choice for many people who need to lower their blood pressure.
This study gives doctors clearer guidance on how to treat high blood pressure more effectively. By using data from millions of patients, it shows that thiazide diuretics could help many people stay healthier and avoid serious heart problems.
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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