Two Common Blood Pressure Drugs Linked to Higher Death Risk, Study Finds

High blood pressure is one of the biggest drivers of heart disease — the leading cause of death in the United States. But a study presented at a major cardiology conference found something unsettling: the choice of which medication you take to control that blood pressure may matter more than doctors once assumed.

Two widely prescribed drug classes were linked to a higher risk of death — not because they fail to lower blood pressure, but because of how unevenly they control it.

The Study

Researchers from the Intermountain Medical Center Heart Institute in Salt Lake City, Utah, presented their findings at the American College of Cardiology (ACC) Scientific Sessions in Orlando, Florida, in March 2018. The team, led by Dr. Brian Clements, analyzed data from more than 10,500 adults with hypertension.

Each patient’s blood pressure was measured at least seven times between January 2007 and December 2011, and researchers tracked which class of blood pressure medication each person was taking. The goal was to see whether certain drug types were linked to greater blood pressure variability — meaning bigger swings in readings from one doctor’s visit to the next. Fronzutolaw

That question mattered because prior research had already shown that patients with large variances in blood pressure between physician visits face an increased risk of death.

The Two Drug Classes Flagged

The study found two classes of blood pressure medication linked to higher blood pressure variability: alpha blockers and alpha-2 agonists.

Alpha blockers — which include doxazosin mesylate and prazosin hydrochloride — work by dilating the blood vessels.
Alpha-2 agonists — such as methyldopa, work by targeting sympathetic nervous system activity, reducing blood vessel constriction.

According to the lead researcher, people on these other types of blood pressure medications have an increased risk of death. It’s worth noting, based on later coverage of the same data, that the increased variability was linked to death risk but not directly to cardiovascular events — an important nuance that separates this from a simple “this pill causes heart attacks” claim.

Which Drugs Looked Safer

The same study pointed to four other commonly prescribed drug classes that appeared to produce steadier blood pressure control and better outcomes:

ACE inhibitors, angiotensin receptor blockers, calcium channel blockers, and thiazide diuretics.

“This study helped us identify blood pressure medications that produce more consistent blood pressure and better mortality outcome data,” said Dr. Clements.

An Important Caveat: It’s Not Just the Pill

Before anyone assumes their prescription is dangerous, it’s worth highlighting what the researchers themselves said. Dr. Clements noted that blood pressure variability isn’t determined by medication alone — the way blood pressure is measured can also have a significant effect on the readings themselves.

In other words, inconsistent measurement technique in clinics can itself inflate “variability,” muddying the picture of how much is truly the drug’s effect.

The researchers framed their conclusion as guidance for prescribers, not as a call for patients to panic — the goal was to help clinicians choose medications that produce more consistent blood pressure readings and, ultimately, better outcomes.

What This Means for You

This was an observational study — it identifies an association, not proof that alpha blockers or alpha-2 agonists directly cause death. These drug classes remain approved, prescribed medications, and they’re sometimes the right — or only — choice for certain patients (for example, alpha blockers are also used to treat enlarged prostate, and alpha-2 agonists like methyldopa are considered particularly safe in pregnancy-related hypertension).

What you should actually do:

Don’t stop or change any blood pressure medication on your own. Health authorities warn that stopping treatment or combining medications without medical supervision can expose patients to serious risks, including heart attacks, strokes, kidney damage, and even death.
Ask your doctor which class of medication you’re on, and whether a switch makes sense given your specific health profile.
Get your blood pressure measured consistently — same arm, same position, same time of day when possible — since measurement technique itself affects the readings that guide treatment decisions.
Watch for big swings in your readings between visits, and mention them to your doctor rather than dismissing an unusually high or low number as a fluke.

The bigger picture, echoed across the cardiology literature, is that consistency of blood pressure control — not just the average number — is what protects long-term health. Well-controlled blood pressure, including through combination therapies tailored to the individual, is linked to a lower risk of heart attack, stroke, heart failure hospitalizations, and death.