High blood pressure is a serious health problem that affects millions of people around the world. If it is not treated, it can lead to dangerous conditions such as heart attacks, strokes, kidney damage, and even early death.
Doctors often prescribe medicine to help keep blood pressure under control, and two of the most common drugs are chlorthalidone and hydrochlorothiazide.
Both medicines belong to a group called diuretics, or “water pills,” which help the body get rid of extra salt and water through urine, making it easier for the heart to pump.
Researchers from Columbia University have now shared the results of a massive 17-year study that followed more than 730,000 people who were taking one of these medicines.
The goal was to see not only how well the drugs worked to prevent heart problems but also to understand their side effects. The study found that while both drugs can lower blood pressure and help prevent serious problems like heart attacks, strokes, and heart failure, there were clear differences in safety.
One of the biggest findings was that people taking chlorthalidone had almost three times the risk of developing very low potassium levels compared to those taking hydrochlorothiazide. Low potassium, or hypokalemia, can be dangerous.
It can cause muscle weakness, confusion, abnormal heart rhythms, and in severe cases, kidney failure or type 2 diabetes. In the study, 6.3% of patients taking chlorthalidone developed hypokalemia, compared to only 1.9% of patients on hydrochlorothiazide.
The researchers also found that chlorthalidone was linked to more cases of other electrolyte imbalances and kidney problems, even when given at lower doses. Electrolytes are minerals in your blood, like sodium and potassium, that help your body work properly. When these levels are off, it can cause serious health issues.
These results have started a discussion about whether chlorthalidone should still be the preferred choice in treatment guidelines, especially when hydrochlorothiazide seems to have fewer risks. If chlorthalidone is prescribed, the study suggests that patients may need closer monitoring to catch and treat side effects early.
Managing high blood pressure is not just about taking medicine. Lifestyle changes are also very important. Eating a healthy diet, exercising regularly, avoiding too much alcohol, quitting smoking, reducing salt intake, and managing stress can all help lower blood pressure. Doctors also recommend checking your blood pressure at home to keep track of your progress.
The lead researcher, Dr. George Hripcsak, and his team published their findings in JAMA Internal Medicine.
They believe this study is important because it shows that doctors should think carefully about the benefits and risks before choosing which medicine to give a patient. It also shows why high blood pressure treatment should be personalized, as each person’s health situation is different.
This research is a major step forward in helping doctors and patients make better decisions about blood pressure treatment. By looking at both the good and bad effects of each drug, healthcare providers can choose safer, more effective options for their patients.
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