A new study from Columbia University has found that a popular drug for high blood pressure, called ACE inhibitors, might not be the best choice for many patients.
The study shows that another type of medicine, called thiazide diuretics, works better and causes fewer side effects.
Doctors have many options when choosing medicine for high blood pressure. These include thiazide diuretics, ACE inhibitors, ARBs, and calcium channel blockers. But there hasn’t been a lot of strong research to clearly say which one is the best to start with. Because of that, doctors often rely on expert opinions and habits rather than large studies.
In this new study, researchers 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 treatments worked best and had the fewest problems.
They found that nearly half of these patients—about 48%—were given ACE inhibitors first. Only 17% were given thiazide diuretics, even though thiazides had better results.
People who started with thiazide diuretics had 15% fewer heart attacks, strokes, and heart failure compared to those who took ACE inhibitors. They also had fewer side effects. In fact, ACE inhibitors were linked to more than a dozen side effects, including kidney problems and long-lasting coughs.
The researchers estimated that if all the patients had started with thiazides instead of ACE inhibitors, about 3,100 major heart problems could have been avoided.
Thiazide diuretics are not new. They’ve been used for many years and work by helping the body get rid of extra salt and water. This helps lower blood pressure. ACE inhibitors also lower blood pressure, but they work in a different way—by relaxing blood vessels.
Both types of drugs can help with high blood pressure, but this new research suggests that thiazides might be the safer and more effective option for many people.
The study was led by George Hripcsak and published in The Lancet. It highlights the need for doctors to think carefully about which medicines they choose first. Using thiazides more often could help prevent heart attacks and reduce side effects for patients.
This research may lead to new guidelines that help doctors choose the best medicine to start with, making sure patients get the safest and most effective treatment possible.
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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