Antihypertensive preferred diuretics safer

Most of the current guidelines, including the China Guidelines for the Prevention and Control of Hypertension, recommend that five types of commonly used antihypertensive drugs can be used as initial therapeutic drugs, including calcium channel blockers (CCB, ground leveling-based), angiotensin conversion enzyme inhibitors (ACEI, prius), angiotensin receptor antagonists (ARBBs, shatts), diuretics (sage-based), and beta-receptor blockers (Lorse)In addition to recommending priority for long-acting drugs and selecting targeted drugs based on the type of population and comorbidities, there is little evidence for most patients with general hypertension to help doctors decide which drug to use firstto obtain reliable conclusions, the team selected health data for 4.9 million patients in the United States, Germany, South Korea and Japan from 1996 to 2018, all of whom chose a single antihypertensive drug for the initial treatment after initial diagnosis of hypertensionIn three key indicators of acute heart attack, hospitalization for heart failure or stroke, as well as six secondary indicators and 46 safety indicators, the team counted more than 20,000 comparative dataAlthough the effects of most drugs are similar, there are several notable differences that have attracted the researchers' attention: patients who prefer the first-line diuretic, compared to the most widely prescribed drug ACEI, have a 16% lower risk of heart attack; The risk of hypothermia and hyponatremia in urethra was 2 to 3 times higher, and patients with preferred ACEI had 19 higher incidences of side effects, such as angioedema, transient cerebral ischemia, kidney disease, platelet reduction, gastrointestinal side effects, etcThe researchers estimate that 3,100 major cardiovascular events could be avoided if patients who preferred ACEI drugs switched to pyrethroidd diuretics during initial treatmentProfessor George Hriboly of Columbia University, one of theresearchers, said the study filled the gap in randomized controlled trials and could help doctors make better clinical decisions.