November 6, 2013
Improved Blood Pressure Guidelines May Prevent More Heart Attacks
Brett Smith for redOrbit.com - Your Universe Online
Rethinking the approach to treating high blood pressure with medication could prevent over one-fourth of heart attacks and strokes, as well as lower the overall use of medication, according to a new study in the journal Circulation.
"Drugs that lower blood pressure are among the most effective and commonly used medications in the country, but we believe they can be used dramatically more effectively," said study author Dr. Jeremy Sussman, an assistant professor of internal medicine at the University of Michigan Medical School.
Study researchers, all from the University of Michigan, said considering a patient’s age, gender and whether or not they smoke is more effective than the conventional one-size-fits-all approach to treating high blood pressure. The team warned that the current method, which is based on target blood pressure values, results in some patients being on too many drugs and others being on too few.
"The purpose of these medications is not actually to avoid high blood pressure itself but to stop heart attacks, strokes and other cardiovascular diseases,” Sussman said. “We should guide use of medications by a patient's risk of these diseases and how much adding a new medication decreases that risk – not solely on their blood pressure level.”
“We found that people who have mildly high blood pressure but high cardiovascular risk receive a lot of benefit from treatment, but those with low overall cardiovascular risk do not,” he added.
When treating people with high blood pressure, doctors typically strive to push readings below 140/80 mmHg. However, the study team said personalized treatment decisions based on a patient's overall risk – and the calculated benefits of advancing treatment – is a considerably more effective model of care.
The Michigan research team said new treatment guidelines could help patients make better decisions about their care. For example, if patients knew that a blood pressure drug only slightly reduced their risk of a heart attack or stroke, they may decide that medication is not the right option for them.
"In addition to resulting in more positive health outcomes for patients, this approach provides the type of information we need to guide individual decisions tailored to the patients' preferences and priorities," said study author Rod Hayward, professor of Medicine and Public Health at the University of Michigan.
"Our research shows how we can estimate how much taking more blood pressure medicine will reduce an individual's risk of heart disease and strokes, so that they and their doctor can make the best decision for them,” he added.
The study comes after the Food and Drug Administration recently approved another drug called Opsumit for treating pulmonary arterial hypertension, a chronic blood pressure condition that can lead to death or the need for lung transplantation.
“Opsumit’s safety and effectiveness were established in a long-term clinical trial where 742 participants were randomly assigned to take Opsumit or placebo,” the FDA said in a statement. “The average treatment duration was about two years. In the study, Opsumit was effective in delaying disease progression, a finding that included a decline in exercise ability, worsening symptoms of PAH or need for additional PAH medication.”