A new study from Columbia University has found that one common drug used to treat high blood pressure may not be the best choice.
The drug is called an ACE inhibitor, and while many doctors use it, the study shows that another drug called a thiazide diuretic might be better for many people.
High blood pressure is a serious health problem that can lead to heart attacks, strokes, and heart failure. To treat it, doctors can choose from several kinds of medicines. These include thiazide diuretics, ACE inhibitors, angiotensin II receptor blockers (ARBs), and calcium channel blockers.
Even though doctors have many options, choosing the best one is not always easy. Most guidelines are based on expert advice, not large research studies. So, a team of scientists decided to study this more carefully.
They looked at data from about 5 million people who had just started taking medicine for high blood pressure. Almost half of them were given ACE inhibitors first. Only 17% were given thiazide diuretics. But the results showed that thiazides might be a better option.
People who started with thiazides had 15% fewer heart problems like heart attacks, strokes, and heart failure compared to those who started with ACE inhibitors. They also had fewer side effects.
ACE inhibitors were linked to 19 different side effects, including problems with the kidneys and long-lasting coughs. These side effects were much less common in people who took thiazides.
The researchers said that if everyone in the study had started with thiazides instead of ACE inhibitors, around 3,100 serious heart problems could have been avoided.
Thiazide diuretics have been used for many years. They work by helping the body get rid of extra salt and water, which lowers blood pressure. ACE inhibitors also lower blood pressure, but they do it by relaxing blood vessels.
Even though both drugs work, this new study shows that thiazides may help people more and cause fewer problems. The researchers say that doctors should think about using thiazides more often as the first treatment for high blood pressure.
This study was led by Dr. George Hripcsak and was published in the medical journal The Lancet. It shows how important it is to use the best research when making medical decisions. It could help change how high blood pressure is treated around the world and improve the health of many people.
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