A large new study from Columbia University has found that a popular drug for high blood pressure may not be the best choice for many people.
The drug, called an ACE inhibitor, is commonly prescribed to help lower blood pressure. But another type of medicine, known as thiazide diuretics, might work better and cause fewer side effects.
Doctors have several types of medicines they can use to treat high blood pressure. These include ACE inhibitors, thiazide diuretics, angiotensin II receptor blockers (ARBs), and calcium channel blockers. But it’s not always clear which one should be used first. Many treatment guidelines are based on expert opinion instead of large real-world studies.
To get a better answer, researchers looked at the medical records of about 5 million people who had just started taking medicine for high blood pressure. They wanted to find out which drugs worked best and caused the least harm.
They discovered that almost half of the patients—48%—started with ACE inhibitors. Only 17% were given thiazide diuretics first. However, those who started with thiazides had better health outcomes.
The results were eye-opening. 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, people who took ACE inhibitors had more problems—19 different side effects, including kidney trouble and a lingering cough. The researchers estimated that if everyone in the study had started with thiazides instead of ACE inhibitors, about 3,100 serious heart events could have been avoided.
Thiazide diuretics have been used for many years. They help the body get rid of extra salt and water through the kidneys, which reduces the amount of fluid in the blood vessels. This helps lower blood pressure. These medicines are also affordable and easy to get.
ACE inhibitors work in a different way. They help relax the blood vessels so the heart can pump blood more easily. They are also useful, but based on this new research, they may not be the best drug to use first.
The study was led by Dr. George Hripcsak and published in the respected medical journal The Lancet. The researchers hope the findings will encourage doctors to consider thiazide diuretics as the first treatment option for high blood pressure.
This study shows how important it is to use the best available data when choosing a treatment. Choosing the right medicine from the start can help people avoid serious health problems and live healthier lives.
If you care about high blood pressure, please read studies that early time-restricted eating could help improve blood pressure, and natural coconut sugar could help reduce blood pressure and artery stiffness.
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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