One blood pressure drug has more health risks than another, study finds

0-One blood pressure drug has more risks than another — Credit: Unsplash+

Researchers at Columbia University have completed a major study on blood pressure medication, one of the largest of its kind. Over 17 years, they tracked more than 730,000 people who were taking medication for high blood pressure.

Their goal was to compare the effects of two commonly used drugs: chlorthalidone and hydrochlorothiazide. Both medications help lower blood pressure and reduce the risk of heart attacks, strokes, and heart failure.

High blood pressure, also called hypertension, is a serious health issue that affects millions of people worldwide. If left untreated, it can lead to heart disease, kidney problems, and even early death.

Doctors often prescribe medications to keep blood pressure under control, and diuretics (also known as “water pills”) are among the most commonly used. These drugs help the body get rid of extra salt and water, which reduces pressure on the blood vessels.

The two medications studied—chlorthalidone and hydrochlorothiazide—belong to this class of drugs. Doctors have prescribed them for decades, but until now, there hasn’t been a clear comparison of their safety. Both medications lower blood pressure effectively, but this new research found that chlorthalidone has more risks than hydrochlorothiazide.

One of the biggest concerns is the impact on potassium levels. Potassium is a mineral that helps keep the heart and muscles working properly. If levels drop too low, a condition called hypokalemia can occur. This can lead to serious health problems, including irregular heartbeats, muscle weakness, confusion, and kidney damage.

The study found that people taking chlorthalidone were nearly three times more likely to develop hypokalemia than those taking hydrochlorothiazide. About 6.3% of patients on chlorthalidone experienced dangerously low potassium levels, compared to only 1.9% of those on hydrochlorothiazide.

The researchers also found that chlorthalidone increased the risk of other problems, such as electrolyte imbalances and kidney issues, even when taken at lower doses.

These findings are important because they may change how doctors decide which medication to prescribe. Until now, some treatment guidelines have favored chlorthalidone, believing it to be slightly more effective at lowering blood pressure.

However, this new research suggests that the increased risks may outweigh the benefits. Experts are now discussing whether treatment recommendations should be updated to reflect these results.

Managing high blood pressure is about more than just taking medication. Lifestyle changes are also essential. Eating a healthy diet with less salt, exercising regularly, quitting smoking, reducing alcohol intake, and managing stress all play a role in keeping blood pressure in check. Monitoring blood pressure at home and having regular doctor visits can help ensure treatment is working.

This study highlights the importance of personalized treatment—choosing the right medication based on an individual’s health needs and risks. The research, led by Dr. George Hripcsak and published in JAMA Internal Medicine, reminds doctors and patients that all medications come with benefits and potential downsides.

For anyone taking blood pressure medication, these findings are a good reason to talk to a doctor about their current treatment plan. Making informed decisions can lead to better long-term health and fewer unexpected risks.