Blood pressure medicines compared: Which pills work best?
Extensive study
Researchers looked into this question. In a secondary analysis of a large study, they compared the long-term effects of the main drug classes used for high blood pressurediuretics, calcium channel blockers, and ACE inhibitors. Notably, the study included a large number of participants (32,804) and a long follow-up timesome were followed for up to 23 years. All participants had mild to moderate high blood pressure at the start and at least one other cardiovascular risk factor. Participants were at least 55 years old at the beginning of the study.
The researchers examined whether taking different medications led to differences in deaths from cardiovascular disease, or the occurrence of conditions like heart disease, kidney disease, or stroke. Was any drug better at preventing these outcomes than the others?
They found that none of the three drug classes was superior. The risk of dying from cardiovascular disease was almost the same in all three groups. Death rates after strokes were also similar across the groups in several analyses.
The researchers thereby support the conclusion that all drug classes are similarly effective for treating high blood pressure.
Conclusion:
There is no single blood pressure medication that can be called the best or most effective for every person with hypertension. Drugs from all major classes can lower blood pressure to a similar extent. That means the most suitable medicine can be chosen individually for each patient.
Sources:
This article comes from BloodPressureDB – the leading app since 2011 that helps hundreds of thousands monitor their blood pressure every day.
Our content is based on carefully researched, evidence-based data and is continuously updated (as of 12/2025).
Author Sabine Croci is a qualified medical assistant with many years of experience in internal medicine and cardiology practices as well as in outpatient care, and has led BloodPressureDB's specialist editorial team since 2015. Thanks to her extensive additional qualifications as a paramedic, first responder and in various therapy and emergency areas, she provides solid, practical and reliably reviewed information.
Author Sabine Croci is a qualified medical assistant with many years of experience in internal medicine and cardiology practices as well as in outpatient care, and has led BloodPressureDB's specialist editorial team since 2015. Thanks to her extensive additional qualifications as a paramedic, first responder and in various therapy and emergency areas, she provides solid, practical and reliably reviewed information.
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