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Study: Some blood pressure medications offer better protection against health effects
Millions of people suffer from hypertension. In some cases, high blood pressure can also be controlled by a healthier lifestyle with lots of exercise and a balanced diet, but medication is often necessary. However, not all medicines for high blood pressure work equally well.
For patients with high blood pressure (hypertension), there are numerous drug treatment options - so many that it can be difficult to figure out which should be used. A new scientific paper published in the specialist magazine "The Lancet" now offers further information on the relative safety and effectiveness of various hypertension medications to inform about this important treatment decision. The study shows that ACE inhibitors may not be the best choice for initial treatment.
How well the main health effects of hypertension were prevented
As part of the study, which also included researchers from Yale University, the data from 4.9 million patients was collected from nine databases in four countries. The researchers said this data was used to compare the safety and efficacy of the five classes of primary hypertension medication, including the popular ACE inhibitors.
They looked at how well each medication prevented the three main health consequences of high blood pressure - heart attack, heart failure (heart failure) and stroke - and to what extent each medication caused 46 unwanted side effects. "This is a remarkable, extensive, multinational study that provides insights that help patients choose their treatment for high blood pressure," said study author Dr. Harlan Krumholz from Yale University.
Inexpensive preparations with a long success story
An important finding was that thiazide or thiazide-like diuretics are better at preventing heart attack, heart failure, and stroke than ACE inhibitors, but are also safer than ACE inhibitors. Taken alone, the differences in safety and efficacy of the treatments may appear small, the researchers say, but if 2.4 million people in the study who are currently using ACE inhibitors used thiazide or thiazide-like diuretics instead, could have avoided more than 3,100 cardiovascular events.
“Given that these drugs are inexpensive and have a long track record of success, the results should move away from the prevailing practice of starting with ACE inhibitors. These results support people who choose thiazide diuretics instead of an ACE inhibitor for the initial treatment of high blood pressure, ”concludes the cardiologist Krumholz.
When antihypertensives become necessary
But when do medications have to be used for high blood pressure? The German Hypertension League explains this on its website: If a person is diagnosed with severe hypertension, then, according to the experts, he should immediately take medication to lower blood pressure. "On the other hand, if the diagnosis is mild or moderate hypertension, those affected should first implement as many of the recommendations for a healthy life as possible," writes the High Pressure League. The main recommendations for a healthy lifestyle are:
- Aim for normal weight
- moderate alcohol consumption
- eat a little table salt
- healthy eating
- Refrain from nicotine
- regular physical activity
- regular daily routine with breaks for rest and relaxation
For some people, their blood pressure drops to the point that medication is not necessary within the first three months after changing their life. If a hypertensive person has not reached safe levels after three months, medication to lower blood pressure is usually necessary. (ad)
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
- Yale University: Not all hypertension drugs are created equal, reports big-data study, (accessed: October 26, 2019), Yale University
- The Lancet: Comprehensive comparative effectiveness and safety of first-line antihypertensive drug classes: a systematic, multinational, large-scale analysis, (accessed: October 26, 2019), The Lancet
- German high pressure league: fight hypertension effectively, (accessed: 26.10.2019), German high pressure league