A new study from Columbia University is challenging the way doctors treat high blood pressure.
This condition affects millions of people and can lead to serious health problems like heart attacks, strokes, and heart failure.
For a long time, doctors have often chosen a type of medicine called an ACE inhibitor as the first treatment for high blood pressure. But new research suggests another medicine may work better—and cause fewer side effects.
There are five main types of drugs that doctors can use to treat high blood pressure. These include thiazide diuretics, ACE inhibitors, ARBs (angiotensin II receptor blockers), and two types of calcium channel blockers.
Choosing which one to start with hasn’t always been clear. Most guidelines are based on expert advice, not direct comparisons.
To find a better answer, researchers from Columbia University looked at health data from nearly 5 million people who began blood pressure treatment. They studied which medicines led to the best health outcomes.
The results were surprising. Even though ACE inhibitors were the most common first choice—used in almost half of the patients—those who started with thiazide diuretics had better results.
People who took thiazide diuretics had 15% fewer serious heart problems like heart attacks, strokes, and 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 have 19 different kinds of side effects, including cough, dizziness, and even more serious issues.
The researchers estimated that if everyone who took ACE inhibitors had started with thiazide diuretics instead, about 3,100 serious heart-related events could have been prevented.
The study, led by researcher George Hripcsak and published in The Lancet, could change the way high blood pressure is treated. It shows that thiazide diuretics may be the best first medicine for many people—not just because they work, but also because they are safer.
If you have high blood pressure, this study is something to know about. The kind of medicine you start with can make a real difference in your health.
If you’re already taking medicine for blood pressure—or planning to start—it’s a good idea to talk to your doctor about your options. Don’t stop or change your medicine without medical advice, but being informed can help you work with your doctor to make the best decision.
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