High blood pressure is one of the most common health conditions in the world. Millions of people take medicine every day to control it and reduce the risk of serious health problems.
Doctors often warn that untreated high blood pressure can quietly damage the body for years before symptoms appear. Because of this, it is sometimes called the “silent killer.”
When blood pressure stays too high for a long time, it puts extra strain on the heart and blood vessels. This can increase the risk of heart attacks, strokes, heart failure, kidney disease, and other dangerous conditions. Finding the best medicine to control blood pressure is therefore very important for long-term health.
A new large study from Columbia University now suggests that many doctors may not be choosing the best medicine to start treatment with.
The researchers found that an older type of blood pressure medicine called thiazide diuretics may work better and cause fewer side effects than ACE inhibitors, which are currently prescribed much more often.
Thiazide diuretics are medicines that help the body remove extra salt and water through the kidneys. This lowers the amount of fluid in the blood vessels, helping blood pressure decrease. These medicines have been used for many decades and are sometimes known as “water pills.”
ACE inhibitors work in a different way. They help relax blood vessels so blood can move more easily through the body. These medicines are also widely used and are often recommended for patients with certain other medical conditions.
To better understand which medicine works best as an initial treatment, researchers studied health records from around 5 million people who had just started taking blood pressure medication for the first time.
The scientists compared patients who began treatment with different kinds of medicines. What they found surprised them.
Nearly half of the patients in the study, about 48%, started with ACE inhibitors. Only about 17% started with thiazide diuretics, even though the older medicine appeared to perform better overall.
The study showed that patients who started with thiazide diuretics had around 15% fewer serious heart-related problems compared to people who started with ACE inhibitors. These problems included heart attacks, strokes, and heart failure.
Researchers also discovered that ACE inhibitors were linked to many more side effects. In fact, the study found 19 different side effects that were more common with ACE inhibitors than with thiazide diuretics.
Some of the most common side effects included kidney problems and a dry, constant cough that many patients found uncomfortable and difficult to tolerate.
The researchers estimated that if all the patients in the study had started treatment with thiazide diuretics instead of ACE inhibitors, around 3,100 major heart-related health events could have been prevented.
These findings suggest that thiazide diuretics may be a safer and more effective first treatment option for many patients with high blood pressure.
So why are ACE inhibitors still prescribed so often? According to the researchers, one reason may simply be habit. Doctors have used ACE inhibitors for many years, and prescribing patterns can sometimes continue even when newer evidence suggests another treatment may work better.
The researchers hope this study will encourage doctors to rethink how they choose blood pressure medicines, especially for patients starting treatment for the first time.
The study was led by George Hripcsak and published in the medical journal The Lancet. Because the study included such a large number of patients, scientists believe the results are strong and important.
Experts say the findings could eventually influence treatment guidelines around the world. If more patients begin treatment with thiazide diuretics, it could help reduce serious heart problems and lower the number of medication side effects experienced by millions of people.
Doctors also remind patients not to stop or change their medication without medical advice. Some patients may still benefit more from ACE inhibitors depending on their medical history and other health conditions. Treatment decisions should always be made together with a healthcare professional.
Still, the study highlights how important it is for medicine to keep improving as new evidence becomes available. Even older drugs can sometimes turn out to be better choices than newer or more popular treatments.
Researchers say continuing to study large groups of patients in real-world settings can help doctors make safer and more effective treatment decisions in the future. This could help many people live healthier lives and avoid unnecessary health problems caused by high blood pressure.
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 information about blood pressure, please see recent studies about How to eat your way to healthy blood pressure and results showing that Modified traditional Chinese cuisine can lower blood pressure.
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