A 17-year study from Columbia University has uncovered important differences between two widely used blood pressure medications—chlorthalidone and hydrochlorothiazide. While both drugs effectively lower blood pressure and reduce the risk of heart attacks, strokes, and heart failure, researchers found that chlorthalidone comes with a higher risk of side effects.
What the Study Found
Researchers followed more than 730,000 patients who were taking these medications for high blood pressure. Over time, they discovered that chlorthalidone increased the risk of low potassium levels (hypokalemia) much more than hydrochlorothiazide.
Hypokalemia is a serious condition where potassium levels drop too low, potentially leading to:
- Irregular heartbeats
- Confusion and dizziness
- Kidney problems
- Increased risk of type 2 diabetes
The study showed that 6.3% of patients taking chlorthalidone developed hypokalemia, compared to only 1.9% of those on hydrochlorothiazide. This means chlorthalidone users were more than three times as likely to experience dangerously low potassium levels.
Beyond hypokalemia, chlorthalidone was also linked to electrolyte imbalances and kidney problems, which in severe cases could lead to kidney failure or heart rhythm abnormalities.
What This Means for Patients
Many doctors currently recommend chlorthalidone as a first-choice treatment for high blood pressure based on older guidelines. However, this study suggests that hydrochlorothiazide may be the safer option for many people, particularly those at risk of potassium imbalances or kidney problems.
For patients already taking chlorthalidone, doctors may consider closer monitoring of potassium and electrolyte levels. In some cases, switching to hydrochlorothiazide may be a better choice.
Managing High Blood Pressure Safely
High blood pressure is a major health risk that can lead to heart disease, stroke, and kidney failure if left untreated. Medications play a crucial role in keeping blood pressure under control, but they should be chosen carefully to minimize side effects.
In addition to medication, lifestyle changes can also help manage blood pressure:
- Healthy diet: Eating more fruits, vegetables, and whole grains while reducing salt and processed foods.
- Regular exercise: Engaging in physical activity like walking, jogging, or cycling.
- Limiting alcohol and quitting smoking: Both habits can raise blood pressure and increase heart risks.
- Stress management: Techniques like meditation, deep breathing, or yoga can help lower stress-related blood pressure spikes.
- Home monitoring: Checking blood pressure regularly can help track progress and guide treatment adjustments.
Looking Ahead
This study, led by Dr. George Hripcsak and published in JAMA Internal Medicine, may lead to a reevaluation of current treatment recommendations. As more research emerges, doctors and patients will be better equipped to choose the safest and most effective blood pressure medications.
The key takeaway is that treating high blood pressure is not just about lowering numbers—it’s also about choosing the right medication that offers the most benefits with the fewest risks. This research helps guide that decision, ensuring better long-term health outcomes for millions of people.
If you care about heart health, please read studies that apple juice could benefit your heart health, and Yogurt may help lower the death risks in heart disease.
For more information about health, please see recent studies that Vitamin D deficiency can increase heart disease risk, and results showing Zinc and vitamin B6 linked to lower death risk in heart disease.
Copyright © 2025 Knowridge Science Report. All rights reserved.
