Medicines used to lower high blood pressure save lives by reducing the risk of heart attacks and strokes.
But research suggests that one type of blood pressure drug may also have an unexpected connection with a common bowel condition.
The condition is called diverticulosis. It develops when small pouches form in weak areas of the wall of the large intestine, and it becomes much more common as people get older.
Many people with diverticulosis never know they have it because the pouches often cause no symptoms. However, complications can sometimes occur, including inflammation, infection or bleeding.
High blood pressure is another very common condition, affecting more than a billion people worldwide. It happens when blood repeatedly pushes against artery walls with too much force, placing extra strain on the heart and blood vessels over time.
Doctors often recommend exercise, a healthier diet, weight management and less salt to help control blood pressure. Many patients also need medicines, particularly when lifestyle changes alone do not lower their readings enough.
Researchers at Imperial College London investigated whether some widely used blood pressure medicines could have effects elsewhere in the body. They focused on three major groups of drugs: ACE inhibitors, beta-blockers and calcium channel blockers.
Instead of giving the medicines to hundreds of thousands of people in a new clinical trial, the researchers used genetic information to explore their possible long-term effects. They examined genes connected with the proteins targeted by these medicines.
The team analyzed genetic data from around 750,000 people. Certain naturally occurring genetic differences can produce effects that resemble what happens when a medicine changes the activity of a particular protein.
By comparing these genetic patterns with a wide range of diseases, researchers could look for unexpected connections between the biological targets of blood pressure medicines and other health conditions. This approach can provide clues about possible drug effects that deserve further investigation.
One result stood out. Genetic patterns that mimicked the effects of a particular group of calcium channel blockers, known as non-dihydropyridine calcium channel blockers, were associated with a higher risk of bowel problems, including diverticulosis.
Calcium plays an important role in muscle contraction. Calcium channel blockers reduce the movement of calcium into certain cells, helping blood vessels relax and making it easier for the heart to pump blood.
But calcium is also important for muscles in the digestive system. These muscles repeatedly contract to move food and waste through the intestines, so changing their activity could potentially affect how the bowel works.
The researchers suggested that this may help explain the link with diverticulosis. However, the study did not prove that taking these medicines directly causes pouches to develop in the bowel.
Genetic studies can reveal possible relationships and help scientists identify effects that may have been overlooked. But they cannot perfectly reproduce what happens when a real patient takes a particular medicine at a particular dose for months or years.
Dr. Dipender Gill, who led the research, emphasized that patients should not stop taking prescribed blood pressure medicines because of the findings. Suddenly stopping treatment can allow blood pressure to rise and may increase the risk of serious cardiovascular problems.
The findings are particularly important because blood pressure medicines are used by millions of people, often for many years. Even an uncommon side effect can matter when a treatment is used on such a large scale.
At the same time, the proven benefits of controlling high blood pressure are substantial. Any possible bowel risk needs to be considered alongside the protection these medicines provide against heart attacks, strokes and other complications.
The research was published in Circulation, a journal of the American Heart Association. It demonstrates how large genetic databases may help scientists uncover unexpected effects of medicines that are already widely used.
More research is needed to confirm whether non-dihydropyridine calcium channel blockers actually increase diverticulosis risk in patients and, if so, how large that risk might be. Future studies could also help doctors identify which patients are most likely to experience unwanted effects.
For now, the findings are a reason for further investigation rather than a reason to avoid blood pressure treatment. People concerned about side effects should discuss them with their doctor, who can weigh the benefits and risks and decide whether a different treatment is appropriate.
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