Establishing High Blood Pressure Drug Characteristics
High blood pressure medications have different characteristics and features — some may be beneficial, but others may be detrimental to you. Be sure you find out about a medication’s main features before you chase a new pill down with a glass of water.
How effective is it?
Doctors like to have proof in the form of medical studies that the drugs are effective and work as advertised. But this process takes ten years or more after a drug has been approved by the Food and Drug Administration (FDA) and comes onto the market, and many of the drugs in this chapter have been around for only a few years. Drug manufacturers often claim that a new drug in the same class as a proven old drug should work the same. However, the new drug may produce side effects that only become apparent after years of use on thousands of people. So you always have to be wary.
How much can it lower blood pressure as compared to another drug?
Up to a certain point, the lower the blood pressure, the better off the patient. However, several studies have shown that when the blood pressure goes below a certain level (which is not the same for each person), the risk of a heart attack increases (possibly because the pressure is so low that not enough blood is reaching the heart muscle). None of the commonly used drugs, when used alone, lower the blood pressure past that point. But of the various classes, thiazide diuretics lower the systolic blood pressure more than the others. (It lowers the diastolic blood pressure about the same as other drugs.)
Do drugs that lower blood pressure to the same extent have the same effect on disease and death?
Thiazide diuretics lower blood pressure more than the other classes of commonly used drugs.
It’s natural to assume that a blood-pressure-lowering drug prevents the longterm consequences of high blood pressure, but this isn’t necessarily the case. Nevertheless, the old standards, especially the thiazide diuretics, have proven effective against long-term consequences.
In fact, the evidence shows that even when a drug other than a thiazide diuretic lowers the blood pressure to the same extent, thiazides prevent disease and death more than other blood-pressure-lowering drugs. If you’ve concluded that I have a definite preference for thiazide diuretics as initial drug treatment for high blood pressure, you’re right.
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