A large study from Columbia University has found that one of the most commonly used drugs to treat high blood pressure may not be the best starting choice.
This drug group is called ACE inhibitors. Instead, another type of medicine known as thiazide diuretics might work better and cause fewer side effects.
Doctors have several options for treating high blood pressure. The main types of drugs include ACE inhibitors, thiazide diuretics, ARBs (angiotensin II receptor blockers), and calcium channel blockers.
But in the past, doctors did not have enough large studies comparing these drugs. So they often chose a treatment based on expert opinions or habits rather than strong evidence.
This new study looked at health records from about 5 million people who were starting treatment for high blood pressure. The researchers wanted to know which medicines worked best to prevent serious heart problems and which ones caused fewer side effects.
They found that nearly half of the patients—around 48%—were given ACE inhibitors first. Only 17% started with thiazide diuretics. However, people who took thiazides had better results. They had 15% fewer serious heart problems like heart attacks, strokes, and heart failure. They also had fewer side effects.
On the other hand, those who took ACE inhibitors were more likely to have problems—19 different kinds of side effects, including kidney issues and a constant dry cough.
The researchers estimated that if all patients had started with thiazide diuretics instead of ACE inhibitors, about 3,100 major heart problems could have been avoided. That’s a big number and shows that choosing the right medicine at the beginning really matters.
Thiazide diuretics are not new. They’ve been used for many years. These drugs help the body remove extra salt and water through the kidneys. This lowers the amount of fluid in the blood vessels and helps reduce blood pressure. They are also cheap and easy to get.
ACE inhibitors work differently. They relax the blood vessels to make it easier for the heart to pump blood. They are effective too, but this study suggests they may not be the best first option for many people.
The lead researcher, Dr. George Hripcsak, says this new information should make doctors think more carefully about which drug to use first. With better results and fewer side effects, thiazide diuretics may be a smarter choice for many patients.
The study was published in the medical journal The Lancet. It supports the idea that doctors should use the best data available when making treatment decisions. Instead of just following tradition, using up-to-date research can lead to better care.
Choosing the right medicine at the start can help lower the risk of serious illness and improve people’s health in the long run.
If you care about high blood pressure, please read studies about what to eat and to avoid for high blood pressure, and 12 foods that lower blood pressure.
For more health information, please see recent studies about the connection between potato and high blood pressure, and how to eat your way to healthy blood pressure.
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