A new study from Columbia University has found that one of the most commonly prescribed medications for high blood pressure, called ACE inhibitors, may not be the best option for many people.
The research shows that another type of drug, thiazide diuretics, could actually work better and cause fewer problems.
When treating high blood pressure, doctors can choose from several kinds of medications. These include thiazide diuretics, ACE inhibitors, angiotensin II receptor blockers (ARBs), and calcium channel blockers. However, doctors don’t always have strong research to guide them on which one to use first. Instead, they often rely on expert opinion or habit.
In this new study, scientists looked at the health records of about 5 million people who had just started taking medicine for high blood pressure. They wanted to see which drugs gave the best results.
The findings were surprising. Nearly half of the patients—about 48%—started with ACE inhibitors. But only 17% were given thiazide diuretics, even though those patients had better health outcomes.
The people who started on thiazide diuretics had 15% fewer major heart problems like heart attacks, strokes, and heart failure compared to those who began treatment with ACE inhibitors.
They also had fewer side effects. In fact, people who took ACE inhibitors had more issues with their kidneys and experienced 19 different side effects, including a common one: a constant cough.
The researchers said that if all the patients in the study had been given thiazide diuretics instead of ACE inhibitors, around 3,100 serious heart problems could have been prevented.
Thiazide diuretics are not a new drug. They have been around for decades and are known to help lower blood pressure by helping the body get rid of extra salt and water through the kidneys. This reduces the pressure in the blood vessels.
ACE inhibitors work in a different way. They relax the blood vessels, which also lowers blood pressure. While both types of medication can be effective, the new study suggests that thiazide diuretics may be a better first option for many patients.
This study challenges the common practice of prescribing ACE inhibitors as the default treatment and encourages doctors to take a fresh look at the benefits of thiazide diuretics.
If doctors change their approach, it could help prevent thousands of serious health problems and make life easier for people with high blood pressure by reducing the chances of side effects.
The study was led by George Hripcsak and published in the journal The Lancet. It highlights the need for medical decisions to be based on solid data. Doctors may want to rethink which drug they choose first when helping patients manage high blood pressure.
If you care about blood pressure, please read studies that new research challenges conventional blood pressure guidelines and scientists make a big breakthrough in high blood pressure treatment.
For more about blood pressure, please read studies that widely used blood pressure drug may increase eye disease risk and common blood pressure drugs linked to cognitive decline.
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