A new study from Columbia University is changing the way doctors think about treating high blood pressure.
The study looked at which blood pressure medicine works best and has fewer side effects. The results showed that a group of drugs called thiazide diuretics may be a better first choice than the more commonly used ACE inhibitors.
High blood pressure is often treated with one of five main types of drugs. These include thiazide diuretics, ACE inhibitors, ARBs (angiotensin II receptor blockers), and two types of calcium channel blockers.
Doctors often follow general guidelines when choosing which one to prescribe, but these guidelines are not always based on direct comparisons between the different drugs.
This new research changed that. Scientists studied medical records and insurance data from almost 5 million people who had just started taking medicine for high blood pressure. Almost half of them—48%—were given ACE inhibitors first. Only 17% started with thiazide diuretics.
The results were surprising. People who started with thiazides were 15% less likely to have serious heart problems, such as heart attacks, heart failure, or strokes. That means thiazides may work better than ACE inhibitors at protecting the heart.
The study also found that thiazides caused fewer side effects. ACE inhibitors were linked to 19 different kinds of problems, including a dry cough that doesn’t go away and high levels of potassium. People on thiazides had fewer of these issues. This suggests that thiazides are easier for the body to handle.
Dr. George Hripcsak, the lead author of the study, said that if all the patients who started with ACE inhibitors had instead used thiazides, about 3,100 major heart problems could have been avoided. That’s a big number and shows how important it is to choose the right medicine.
The research was published in The Lancet, one of the world’s top medical journals. The scientists say that doctors should think about giving thiazide diuretics first when starting blood pressure treatment. With better results and fewer side effects, thiazides may be the smarter and safer choice for many people.
This large study helps give doctors better information. Instead of relying only on expert opinions, they now have strong data to support using thiazides as a first step in treating high blood pressure. Making this change could help many people live longer and healthier lives.
If you care about blood pressure, please read studies about unhealthy habits that could increase high blood pressure risk, and people with severe high blood pressure should reduce coffee intake.
For more information about blood pressure, please see recent studies that early time-restricted eating could help improve blood pressure, and results showing plant-based foods could benefit people with high blood pressure.
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