A large study from Columbia University has looked at the safety and effectiveness of two common blood pressure medications: chlorthalidone and hydrochlorothiazide.
The study lasted 17 years and included more than 730,000 people who were being treated for high blood pressure.
Both of these medications are used to help prevent heart problems like heart attacks, strokes, and heart failure. The study found that both drugs worked equally well for those purposes. However, one of the drugs – chlorthalidone – was linked to more serious side effects than the other.
People who took chlorthalidone were almost three times more likely to have very low levels of potassium in their blood. They also had a higher chance of problems with other body chemicals, called electrolytes, and more issues with their kidneys.
These problems can lead to dangerous health conditions, like irregular heartbeats, low sodium levels (also called hyponatremia), confusion, kidney damage, and even type 2 diabetes.
To give a clearer picture, the study showed that 6.3% of the people who took chlorthalidone had low potassium, while only 1.9% of those on hydrochlorothiazide had this issue. Even when chlorthalidone was given in smaller amounts, the risk of low potassium was still higher.
Because of these findings, the researchers are asking doctors and health experts to take another look at current treatment guidelines.
Right now, chlorthalidone is often the preferred choice, but this study suggests that its safety may not be as good as once thought. Doctors who prescribe chlorthalidone are encouraged to watch their patients closely for any signs of these side effects.
This is not the first time chlorthalidone has been linked to problems with electrolytes. Previous studies had seen similar patterns, and this new research supports those earlier warnings.
High blood pressure is a serious health issue that can lead to heart attacks, strokes, and kidney problems. But the good news is that it can be treated in different ways.
One way is with medicine. There are many kinds, including the two mentioned in the study, plus others like ACE inhibitors, beta-blockers, and calcium channel blockers. Each person might need a different type depending on their health.
Another important part of treatment is changing your lifestyle. This includes eating healthy foods, cutting back on salt, staying active, losing extra weight, avoiding too much alcohol, and not smoking.
Managing stress is also helpful. Stress can make blood pressure worse, so things like meditation, yoga, or just taking time to relax can make a difference.
People with high blood pressure should also go to regular check-ups. This helps doctors see how things are going and change the treatment plan if needed. Checking your blood pressure at home is a good idea too.
This big study, led by George Hripcsak and his team, was published in JAMA Internal Medicine. It gives doctors and patients new information to help choose the safest and most effective treatment. And it shows how important it is to keep doing research that helps improve care for common conditions like high blood pressure.
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