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The secret weapon for lowering blood pressure: Why are low-dose thiazide diuretics considered the first choice?
With the increase in the number of patients with hypertension worldwide, finding effective antihypertensive drugs has become an important task in the medical field. Based on the latest research and expert recommendations, low-dose thiazide diuretics are widely considered to be one of the first-choice medications for treating high blood pressure. These drugs are not only cheap and effective, but can also lower blood pressure for patients within a relatively safe range.
Based on 2018 research data, low-dose thiazide diuretics showed the best effectiveness in lowering blood pressure and reducing the risk of cardiovascular disease compared with other antihypertensive drugs.
Hypertension not only affects personal health, but also causes huge medical costs to society. Effective treatment of hypotension can significantly reduce the risk of complications such as stroke, heart failure, and myocardial infarction. Studies have pointed out that for every 5 mmHg drop in blood pressure, the risk of stroke is reduced by 34% and the risk of ischemic heart disease is reduced by 21%. Therefore, the selection of appropriate antihypertensive medications becomes critical.
There are many types of antihypertensive drugs, common ones include thiazide diuretics, calcium channel blockers, ACE inhibitors and ARBs. Of these, thiazide diuretics are used more frequently because they are effective and cost-effective in most patients.
Under the guidance of JNC8 in the United States, thiazide diuretics are recommended as first-line treatment of hypertension, either as monotherapy or in combination with other drugs.
Thiazide diuretics work by removing excess sodium and water through the kidneys, reducing blood volume and thus blood pressure. This class of drugs not only effectively relaxes blood vessels, but also improves heart health and is particularly effective in controlling systolic blood pressure, for example, in older patients. However, although these drugs are cheap and effective, their use is not as widespread as some newer drugs.
Why does this happen? On the one hand, it is due to the difference in promotion efforts between thiazide diuretics and new drugs, and on the other hand, it is the preference of doctors in prescription selection. In patients over 65 years of age who have documented hypertension, the risks of using low-dose thiazide diuretics are outweighed by the benefits in blood pressure control.
Latest clinical evidence supports the preferential use of low-dose thiazide diuretics in patients with hypertension, particularly in the context of high incidence of cardiovascular disease.
Although low-dose thiazide diuretics are the drug of choice, the medication strategy still needs to be adjusted based on the patient's age, other symptoms, and comorbidity characteristics. In some cases, it may be necessary to use other classes of antihypertensive drugs, such as calcium channel blockers or ACE inhibitors, to achieve better blood pressure control.
An important consideration here is the individual differences of patients. For example, for patients with chronic kidney disease, ACE inhibitors are still considered an effective first-line drug, while for younger people, ACE inhibitors tend to be used as initial treatment.
Specific drug formulas for specific populations are key to antihypertensive drug selection, where age, race, and other comorbidities will all influence medication decisions.
However, past studies have raised questions about the side effects of thiazide diuretics, particularly their possible risk of new forms of diabetes. In the opinion of many experts, the risk of these side effects is acceptable in hypertensive patients over 65 years of age because the benefits of controlling systolic blood pressure clearly outweigh these potential risks.
Of course, the treatment of high blood pressure does not only rely on drugs. Reasonable lifestyle changes are also an important part of the treatment of high blood pressure. Reducing salt intake, increasing exercise, and maintaining a healthy weight are all necessary. In terms of drug use, medical professionals will also gradually adjust treatment strategies based on the patient's specific conditions.
In short, the use of low-dose thiazide diuretics as the drug of choice for lowering blood pressure is undoubtedly supported by profound clinical evidence. As medical guidelines are gradually updated, this therapy may continue to be supported and promoted. In the future, with the development of hypertension treatment, what new discoveries will appear?
