A recent study published in JAMA Network examined the effects of three common blood pressure medications on mortality and other health outcomes. The study analyzed data from over 32,000 participants with high blood pressure and found that the risk of cardiovascular disease mortality was similar regardless of the type of medication used. However, further analysis revealed an 11% increased risk of fatal and nonfatal stroke associated with ACE inhibitors compared to diuretics.
These findings highlight the need for additional research to explore the potential risks of medications like ACE inhibitors. High blood pressure, which is defined as the pressure of blood pushing against the walls of arteries, can lead to serious complications such as stroke, heart attack, heart failure, or vision loss.
While lifestyle changes such as exercise, alcohol reduction, and sodium intake reduction can help manage high blood pressure, many individuals require medication for effective control. The three common types of medications used are thiazide-type diuretics, calcium channel blockers, and ACE inhibitors. Despite their different mechanisms of action, all three medications are effective in lowering blood pressure.
The study in question was a secondary analysis of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). Researchers followed up with participants for up to twenty-three years, collecting data from various sources. The analysis included 32,804 participants aged 55 or older with high blood pressure and other risk factors for coronary heart disease.
The results of the study showed a similar risk of cardiovascular disease mortality among all medication types. However, ACE inhibitors were associated with an 11% increased risk of fatal and nonfatal stroke compared to diuretics. It is important to note that after adjusting for multiple comparisons, this increased risk was not statistically significant.
The study does have some limitations. It cannot establish a causal relationship between factors, and there may be potential bias once participants were unblinded. Additionally, there was missing data on post-trial medication use, and the researchers were unable to follow up with all participants or collect laboratory data and blood pressure readings after the trial.
Medical professionals not involved in the study emphasize the importance of ongoing monitoring and personalized treatment plans for individuals with high blood pressure. Given the observed differences in outcomes over an extended period of time, shared decision-making between clinicians and patients is crucial.
In conclusion, the long-term management of high blood pressure is essential for improving overall health. While medications can effectively control blood pressure, further research is needed to understand the potential risks associated with specific medications. Lifestyle changes and personalized treatment plans can help individuals with high blood pressure achieve better health outcomes.