???Our findings suggest that physicians should use renin levels to predict the most appropriate first drug for treating patients with hypertension,??? says lead author Michael Alderman, M.D., professor of epidemiology & population health and of medicine at Einstein. ???This would increase the likelihood of achieving blood pressure control and reduce the need for patients to take additional antihypertensive medications.???

The study involved 945 patients who were enrolled in a workplace antihypertensive treatment program in New York City from 1981 to 1998. 

They said a mismatch between drugs and patient characteristics may help explain why many people do not benefit from blood pressure drugs, and testing for renin levels may help.

“The one-size-fits-all approach must be abandoned,” said Dr. Curt Furberg of Wake Forest University School of Medicine in North Carolina, who wrote a commentary on the studies in the American Journal of Hypertension.

Paul Whelton, MB, MD, MSc, reported the results on Aug. 13 at the plenary session of the China Heart Congress and International Heart Forum in Beijing. Whelton is president and CEO of Loyola University Health System and chairman of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heat Attack Trial (ALLHAT), which has examined the comparative value of different blood pressure-lowering medications.

More than 33,000 patients with high blood pressure were randomly assigned to take either a diuretic (chlorthalidone) or one of two newer drugs, a calcium channel blocker (amlodipine) or an ACE inhibitor (lisinopril).

???Although blood concentrations of cholesterol and triglycerides have long been known as risk factors for cardiovascular disease, the extent to which genetics contributes to those concentrations and just how alterations in the underlying genes leads to the development of disease has been incredibly difficult to piece together,??? said Dr. Sekar Kathiresan, director of Preventive Cardiology at Massachusetts General Hospital (MGH), an associate member of the Broad Institute of Harvard and MIT, and co-senior author on both papers. ???In these two papers, we provide 95 signposts indicating genes that contribute to plasma lipid concentrations. In addition, we delve deeper into one specific signpost and move from genomic localization to biologic understanding by discovering how genetic variation leads to clinical symptoms in living organisms. We believe our approach is a model for many other such studies across multiple diseases.???

As expected, the study found that overweight or obese people were more likely to have a high systolic blood pressure - the top number in a blood pressure reading. But for those with a high body mass index (BMI) - a measure of weight versus height—how in shape they were only had a small impact on their blood pressure.

The results suggest that people who are trying to decrease their risk for high blood pressure should focus on losing weight however they can most effectively do that, the authors say, and that increasing physical fitness should be a secondary goal.

According to the study published in Hypertension: Journal of the American Heart Association, the research team assessed how teenage boys and girls with normal blood pressure might progress into becoming young adults with hypertension. Currently, systolic blood pressures of 100 to 110 and even up to 120 are considered within the normal range for adolescents. Other traits like weight, height and body mass index (BMI) have a range of distribution that is considered “normal.”

“Frequently called the ‘silent killer,’ hypertension is a major risk factor for heart disease and vascular diseases like stroke,” explains researcher Dr. Assaf Rudich, an associate professor in the Department of Clinical Biochemistry at BGU. “It is increasing along with the obesity epidemic, but regrettably, young adults who are otherwise healthy frequently are not screened for becoming hypertensive.”

They found that using a combination of drugs to keep diabetic patients’ top blood pressure readings below 130 offered no benefit over those whose top reading was below 140 - the cutoff point for high blood pressure.

Normal blood pressure for healthy people is considered to be 120/80 or lower.

Hypertension is the most common chronic condition in developed countries and a major risk factor for heart and kidney diseases. Researchers are striving to identify environmental factors that might be responsible for the development of hypertension, and they suspect that fructose may play a role. Over the past century, a dramatic increase in the consumption of this simple sugar, which is used to sweeten a wide variety of processed foods, mirrors the dramatic rise in the prevalence of hypertension.

To examine whether increased fructose consumption has contributed to rising rates of hypertension, Diana Jalal, MD (University of Colorado Denver Health Sciences Center) and her colleagues analyzed data from the National Health and Nutrition Examination Survey (2003-2006). 

Although not all studies agree, the findings add to a growing body of evidence that too much of the ubiquitous sugar—found in fruits as well as high-fructose corn syrup and table sugar—can have important health consequences. (See Reuters Health story of May 24, 2010.)

High blood pressure, for example, increases the risk of strokes, heart disease and kidney failure. 

The Japanese drug maker said at the 70th annual Scientific Sessions of the American Diabetes Association in Orlando, Fla., that the single-pill triple combination of Benicar (olmesartan medoxomil), amlodipine and hydrochlorothiazide in the respective 40 mg, 10 mg and 25 mg strengths resulted in a statistically significant reduction in blood pressure compared with Benicar and hydrochlorothiazide or amlodipine and hydrochlorothiazide. Amlodipine, which Pfizer sells under the brand name Norvasc, and hydrochlorothiazide are widely available as generics.

The phase 3 trial, called ???TRINITY,??? enrolled 2,492 patients, of whom 15.5% had hypertension and diabetes. 

NSAIDs such as Ibuprofen, used to treat conditions such as arthritis are available over the counter and can raise blood pressure. Ibuprofen increases blood pressure by causing water retention.  A study produced by the Journal Hypertension, showed that women who took 400mg of Ibuprofen daily had between 60-80% increased risk of developing high blood pressure compared to those who did not take Ibuprofen.

The same study demonstrated that women who took 500mg of acetaminophen each day were twice as likely to suffer from high blood pressure compared to those who never took acetaminophen. 

Worse, the number of Filipinos with hypertension continues to increase, including those addicted to high salt snacks and other processed foods, according to HEALTHbeat, the official publication of the Department of Health (DoH).

Citing the latest figures from the National Nutrition and Health Survey of the Food and Nutrition Research Institute (FNRI), HEALTHbeat said the number of hypertensive adults had increased to more than 25.3 percent compared to 22 percent in 2003.

Dr Karin Ried worked with a team of researchers from the University of Adelaide, Australia, to conduct the analysis. She said, “Flavanols have been shown to increase the formation of endothelial nitric oxide, which promotes vasodilation and consequently may lower blood pressure. There have, however, been conflicting results as to the real-life effects of eating chocolate. We’ve found that consumption can significantly, albeit modestly, reduce blood pressure for people with high blood pressure but not for people with normal blood pressure”.

The pressure reduction seen in the combined results for people with hypertension, 5mm Hg systolic, may be clinically relevant ??“ it is comparable to the known effects of 30 daily minutes of physical activity (4-9mm Hg) and could theoretically reduce the risk of a cardiovascular event by about 20% over five years.

The European Medicines Agency said its Committee for Medicinal Products for Human Use (CHMP) was prompted to reassess the risks of ARBs by a study reviewing nine trials involving almost 95,000 patients that suggested the drugs may be linked with “a modestly increased risk of new diagnoses of cancer when compared with placebo or other heart medicines.”

The study, known as a meta-analysis and published by U.S. researchers earlier this month, looked at all the publicly available data and found that patients were 1.2 percent more likely to be diagnosed with a new cancer over four years than people who did not take the drugs. 

Many people have hypertension without knowing it. Hypertension remains the most threatening risk factor for developing cardiovascular diseases such as stroke and heart failure.
For instance, studies from South Africa found that 32.1 per cent of men and18.9 per cent of women over 30 years had a 20 per cent or higher risk of developing CVD in the next 10 years.

From one part of the continent to another, contributions of indigenous knowledge to native remedies of hypertension vary. This is obvious from information on the therapies for high blood pressure in the Yoruba speaking communities of Ilugun area of Ogun State.