A large long-term study has provided new information about two widely used medications for high blood pressure, offering important guidance for both doctors and patients.
High blood pressure, also called hypertension, affects hundreds of millions of people worldwide and is a major cause of heart disease, stroke, kidney failure, and early death. Because it often causes no clear symptoms, many people may not even know they have it until serious damage has already occurred. For this reason, effective treatment is essential.
Researchers at Columbia University led a major study that followed more than 730,000 people with high blood pressure over a period of 17 years. The goal was to compare two commonly prescribed medicines: chlorthalidone and hydrochlorothiazide.
Both drugs belong to a group called diuretics, sometimes known as water pills. They help the body remove extra salt and water through urine, which lowers blood pressure and reduces strain on the heart and blood vessels.
For many years, both medications have been considered reliable treatments. They are often used as first-line therapy because they are effective and relatively affordable. However, the new study found that while both drugs work well to control blood pressure, chlorthalidone may cause more side effects than hydrochlorothiazide.
One of the most important concerns identified in the study was the risk of low potassium levels, a condition known as hypokalemia. Potassium is a vital mineral that helps regulate heart rhythm, muscle function, and nerve signals.
When potassium levels drop too low, it can lead to serious health problems such as irregular heartbeat, weakness, confusion, kidney issues, and in severe cases, life-threatening complications.
The study showed that 6.3 percent of people taking chlorthalidone developed low potassium levels, compared with only 1.9 percent of those taking hydrochlorothiazide. This means the risk was nearly three times higher with chlorthalidone.
The researchers also found higher rates of other problems among chlorthalidone users, including imbalances in body salts and signs of kidney trouble. These risks appeared even when patients were given lower doses of the medication.
These findings have raised questions about how strongly chlorthalidone should be recommended in treatment guidelines. Some doctors have preferred it because earlier studies suggested it might control blood pressure slightly better.
However, the new evidence suggests that safety should also be carefully considered. Doctors may need to monitor patients more closely if they prescribe chlorthalidone, especially by checking blood tests to ensure potassium levels remain safe.
Managing high blood pressure requires more than just medication. Doctors usually advise a combination of treatments that include healthy lifestyle changes.
Eating a balanced diet with less salt, staying physically active, maintaining a healthy weight, limiting alcohol, quitting smoking, and managing stress can all help lower blood pressure naturally. Regular checkups and home monitoring are also important so that any changes can be detected early.
The study highlights the importance of personalized treatment. Every person’s body responds differently to medication, and what works well for one patient may not be ideal for another.
Age, other health conditions, and individual risk factors all play a role in deciding which drug is most suitable. By carefully weighing benefits and risks, doctors can choose the safest and most effective option for each patient.
This research, published in JAMA Internal Medicine and led by George Hripcsak, provides valuable insight into improving care for people with hypertension. It suggests that while both drugs can lower blood pressure, hydrochlorothiazide may be the safer choice for many patients due to its lower risk of side effects.
In the end, controlling high blood pressure is essential for protecting long-term health. With the right treatment plan, regular monitoring, and healthy lifestyle habits, people can greatly reduce their risk of heart attack, stroke, and other serious complications. Working closely with healthcare providers ensures that treatment is both effective and safe.
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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