Tag: hypertension

Categories : Cardiovascular DiseaseTags :

An Extra Drug or More of the Same for Uncontrolled Hypertension?

On By ModernMedia
Source: Unsplash

A new study may help people with uncontrolled hypertension and their doctors decide whether to increase the dose of one of their existing drugs, or add a new one, to bring down their blood pressure.

Reviewing data from veterans over age 65 receiving treatment over two years, researchers found that patients have a better chance of adhering to their medication regimen if their doctor maximises the dosage of one of the drugs they’re already taking. While both strategies decrease blood pressure, they found adding a new medication has a very slim advantage over increasing the dose of an existing medication, despite some of the patients being unable to stay on the new medication.

In the end, the researchers say, the new findings could add to discussions between physicians and patients whose blood pressure remains elevated despite starting medication treatment.

The findings, reported in the Annals of Internal Medicine, focus on patients whose initial systolic blood pressure was above 130mmHg.

By looking back at VA and Medicare data, the researchers were able to see patterns in treatment and blood pressure readings over time, in a kind of natural experiment. All the patients were taking at least one blood pressure medication at less than the maximum dose and had a treatment intensification at the start of the study period, indicating that their physicians thought they needed more intense treatment.

Intensifying treatment must be carefully considered, as there are many concerns — whether a drug interaction if a new drug is added, or an electrolyte imbalance with high doses, or fainting and falling if a person’s pressure gets too low .

This is the first time the two approaches have been compared, said first author Dr Carole E. Aubert.

“There’s increasing guidance on approaches to starting treatment in older adults, but less on to the next steps to intensify treatment, especially in an older and medically complex population that isn’t usually included in clinical trials of blood pressure medication,” she said. “How can we increase medications safely in a population already taking many medications for hypertension and other conditions.”

“Treatment guidelines do suggest starting treatment with multiple medications, and clinicians are comfortable with an approach of ‘starting low and going slow’ in older patients,” said senior author Dr Lillian Min. “But these results show that in older patients, we have further opportunity to tailor choices in intensifying drug therapy for hypertension, depending on the individual patient’s characteristics.”

She continued, “Is the patient more likely to stick to a simpler regimen? Then increase an existing medication. Or is the blood pressure very high and the clinician is more concerned about reducing it? Then consider starting a new medication now.”

For older adults already on various medications, overcomplicating it with another pill may be excessive. The risks of polypharmacy are already well known, Dr Min said.

Source: University of Michigan

Categories : Cardiovascular DiseaseTags :

Home BP Monitoring Gets the Thumbs-up From Patients

On By ModernMedia
BP cuff for home monitoring, Source: Pixabay

Adults needing to track their blood pressure regularly for a hypertension diagnosis preferred home monitoring blood pressure versus at a clinic, kiosk or with a 24-hour wearable device, according to preliminary research presented at the American Heart Association’s Hypertension Scientific Sessions 2021.

According to the American Heart Association, about half of US adults have hypertension, and of those with high blood pressure (BP) over a third are unaware they have it. H

“Most hypertension is diagnosed and treated based on blood pressure measurements taken in a doctor’s office, even though the U.S. Preventive Services Task Force and the American Heart Association recommend that blood pressure measurements be taken outside of the clinical setting to confirm the diagnosis before starting treatment,” said lead study author Beverly Green, MD, MPH, senior investigator and family physician at Kaiser Permanente Washington Health Research Institute. “It is the standard that blood pressure monitoring should be done either using home blood pressure monitoring or 24-hour ambulatory blood pressure monitoring prior to diagnosing hypertension.”

The “gold standard” for out-of-office measurement to determine a diagnosis of high blood pressure is 24-hour ambulatory blood pressure monitoring devices, worn day and night to take continuous blood pressure readings. Measuring BP on a home device with a normal BP cuff, can be more convenient.

The researchers studied adherence and acceptability of different blood pressure measuring methods among 510 adults with elevated BP but without a hypertension diagnosis. Participants in the study were an average age of 59 years old; half were male; the average BP was 150/88 mm Hg and were taking blood pressure-lowering medications.

Participants were randomised to either clinic measurements, home monitoring or kiosk blood pressure monitoring.

Those in the group for clinic measurements were asked to return to the clinic for at least one additional blood pressure check, as is routine in diagnosing hypertension in clinical practice. The home group received home blood pressure machines and the training to use them, and were asked to measure their blood pressure twice in a row, two times daily, for five days, for a total of 20 measurements. The kiosk group was asked to take their blood pressure at a kiosk in their clinic or at a nearby pharmacy three times each on three separate days, for a total of nine measurements. All participants were asked to complete their group-assigned diagnostic regimens within three weeks, and then to complete 24-hour ambulatory blood pressure monitoring. Researchers compared adherence to and the acceptability among each diagnostic method.

They measured adherence to monitoring by noting the percent of individuals in each group who completed their assigned measurement method as instructed. They measured acceptability with questionnaires.

Researchers found that overall acceptability was highest for the at-home group, followed by the clinic and kiosk groups, while 24-hour ambulatory blood pressure monitoring was the least popular. Adherence to the monitoring regimen was lowest in the kiosk group, but more than 90% in the home testing group; more than 87% in the clinic group; nearly 68% in the kiosk group; and 91% for 24-hour ambulatory monitoring among all participants.

“Home blood pressure monitoring was the most preferred option because it was convenient, easy to do, did not disturb their daily personal or work routine as much, and was perceived as accurate,” said Dr Green. “Participants reported that ambulatory blood pressure monitoring disturbed daily and work activities, disrupted sleep and was uncomfortable.”

When asked which diagnostic testing regimen they would prefer, more than half chose home blood pressure monitoring, especially if they were assigned to the home group, where almost 80% preferred home monitoring.

Dr Green suggests that clinicians routinely offer home blood pressure monitoring to their patients with elevated blood pressure.
“Health care professionals should work toward relying less on in-clinic visits to diagnose hypertension and supporting their patients in taking their blood pressure measurements at home,” Dr Green said. “Home blood pressure monitoring is empowering and improves our ability to identify and treat hypertension, and to prevent strokes, heart attacks, heart failure and cardiovascular death.”

Source: American Heart Association

Categories : Obstetrics & GynaecologyTags :

Taking Action Before and Between Pregnancies Reduces Risk of Preeclampsia

On By ModernMedia
Credit: Thirdman on Pexels

In a new study, John Hopkins researchers have found that the periods before pregnancy and in between pregnancies are crucial times to address preeclampsia risk factors like obesity, diabetes and hypertension.

Preeclampsia, a common pregnancy complication, is characterised by high blood pressure and signs of damage to the liver, kidneys or other organs. It usually starts after 20 weeks of pregnancy in women whose blood pressure had previously been normal. .

The team, led by S. Michelle Ogunwole, MD, a fellow in the Division of General Internal Medicine, and Wendy Bennett, MD, MPH, associate professor of medicine, both at the Johns Hopkins University School of Medicine, published their findings in the Journal of the American Heart Association.

Dr Ogunwole said: “Preconception health care is really important as it’s a window of opportunity to think about your future health. We encourage patients to work on chronic disease issues before their pregnancies and between their pregnancies.”

A woman who develops preeclampsia during her first pregnancy has a higher risk of the condition recurring in a second or any successive pregnancies, she said.

“As an internist concerned about maternal outcomes, I am interested in what health care providers can do to help women reduce their risk of preeclampsia, including being a big proponent of preconception counseling,” said Dr Ogunwole.

The team compared two sets of women who were participating in the Boston Birth Cohort. Since 1998, the cohort has looked at a broad array of early life factors and their effects on pregnancy, infancy and child health outcomes. The researchers wanted to understand the differences between women who developed preeclampsia and those who did not, and how a first case of the condition affects subsequent pregnancies. Dr Ogunwole’s team studied 618 women to gain “rich maternal health data among racially and ethnically diverse pregnant women.”

“We wanted to make sure that we’re asking questions in a population that looks like the populations we serve,” she says. “I’m interested in the life course of women and pregnancy complications that can shape the trajectory of their future health.”

The researchers found that obesity, diabetes, high blood pressure, gestational diabetes and preterm birth were common factors in women who had preeclampsia during both first and second pregnancies, or who developed the condition during gestation with a second or later child.

“We know that improving weight will improve other conditions, so we advise that women create healthier lifestyles before and between pregnancies,” said Dr Ogunwole. “Whether you have another pregnancy again or not, you can still improve your overall health.”

Future research should hopefully include larger trials to confirm their results. Dr  Ogunwole  also plans to study the structural barriers that may prevent women from engaging in healthy lifestyles and develop strategies to improve long-term health outcomes for women.

Source: John Hopkins Medicine

Categories : Cardiovascular Disease Diet and NutritionTags :

Gut Microbiome Moderates BP Benefits of Flavonoids

On By ModernMedia
Photo by Melissa Walker Horn on Unsplash

Flavonoid-rich foods, such as berries, apples, pears and wine, seem to reduce hypertension due in part to characteristics of the gut microbiome, according to a new study published in Hypertension.

“Our gut microbiome plays a key role in metabolising flavonoids to enhance their cardioprotective effects, and this study provides evidence to suggest these blood pressure-lowering effects are achievable with simple changes to the daily diet,” said lead researcher Aedín Cassidy, PhD, chair and professor in nutrition and preventive medicine at the Institute for Global Food Security at Queen’s University.

Flavonoids are compounds found naturally in fruits, vegetables and plant-based foods such as tea, chocolate and wine. They have miscellaneous favourable biochemical and antioxidant effects associated with various diseases such as cancer, Alzheimer’s disease, atherosclerosis, etc. Flavonoids are broken down by the body’s gut microbiome. Recent studies found a link between gut microbiota, the microorganisms in the human digestive tract, and cardiovascular disease (CVD). Gut microbiota are highly individual, and seem to be associated with CVD.

With studies suggesting flavonoids may reduce heart disease risk, the researchers investigaged the role of the gut microbiome in this. 
Researchers drew on a group of 904 adults between the ages of 25 and 82, 57% men from Germany’s PopGen biobank. Researchers evaluated the participants’ food intake, gut microbiome and blood pressure levels together with other clinical and molecular phenotyping at regular follow-up examinations.

Participants’ intake of flavonoid-rich foods during the previous year was calculated from a self-reported food questionnaire detailing the frequency and quantity eaten of 112 foods.

Participants’ gut microbiomes were assessed by faecal bacterial DNA in stool samples. After an overnight fast, participants’ blood pressure levels were measured. Researchers also collected participants’ lifestyle information, and measured BMI and other physical characteristics,

The analysis found that:

  • Study participants with the highest intake of flavonoid-rich foods, including berries, red wine, apples and pears, had lower systolic blood pressure levels, as well as greater gut microbiome diversity than the participants with the lowest levels of flavonoid-rich food intake.
  • Up to 15.2% of the association between flavonoid-rich foods and systolic blood pressure could be explained by the diversity found in participants’ gut microbiome.
  • Eating 1.6 servings of berries per day (one serving = 80 grams, or 1 cup) was associated with an average reduction in systolic blood pressure levels of 4.1 mm Hg. 12% of the association was explained by gut microbiome factors.
  • Drinking 2.8 glasses (125 ml of wine per glass) of red wine a week was associated with an average of 3.7 mm Hg lower systolic blood pressure level, of which 15% could be explained by the gut microbiome.

“Our findings indicate future trials should look at participants according to metabolic profile in order to more accurately study the roles of metabolism and the gut microbiome in regulating the effects of flavonoids on blood pressure,” said Cassidy. “A better understanding of the highly individual variability of flavonoid metabolism could very well explain why some people have greater cardiovascular protection benefits from flavonoid-rich foods than others.”

While this study suggests potential benefits to consuming red wine, the American Heart Association suggests that if you don’t drink alcohol already, you shouldn’t start.

Study limitations include not being able to account for all factors, such as genetics and lifestyle. The authors noted the focus of this study was on specific foods rich in flavonoids, not all food and beverages with flavonoids.

Source: Medical Xpress

Categories : Cardiovascular DiseaseTags :

Parental History Not The Only Premature Heart Attack Risk

On By ModernMedia
Image source: Unsplash CC0

A new study has shown that, while parental history is a contributing factor, young heart attack victims are more likely to be smokers, obese, and have high blood pressure or diabetes compared to their peers.

“The findings underline the importance of preventing smoking and overweight in children and adolescents in order to reduce the likelihood of heart disease later in life,” said study author Professor Harm Wienbergen of the Bremen Institute for Heart and Circulation Research.

“Understanding the reasons for heart attacks in young adults is important from a societal perspective due to their employment and family responsibilities,” he continued. “However, there are limited data on the predictors of heart events in this group.”

The researchers compared the clinical characteristics of consecutive patients admitted to hospital with acute myocardial infarction at 45 years of age or younger against randomly selected individuals from the German population. Cases and controls were matched according to age and gender. The case-control study enrolled a total of 522 patients with 1191 matched controls from a national database.

The researchers found that the proportion of active smokers was more than three-fold higher in the young heart attack group compared to the general population (82.4% vs 24.1%). Patients were more likely to have high blood pressure (25.1% vs 0.5%), diabetes (11.7% vs 1.7%) and a parental history of premature heart attack (27.6% vs 8.1%) compared to their peers. Patients were more often obese, with a median body mass index (BMI) of 28.4 kg/m2 compared to 25.5 kg/m2 for controls. In contrast, the proportion consuming alcohol at least four times a week was higher in the general population (11.2%) compared to heart patients (7.1%).

The researchers analysed the independent risk factors for the occurrence of acute myocardial infarction at 45 years of age or younger. The analysis was adjusted for age, sex, high blood pressure, diabetes, active smoking, body mass index, alcohol consumption, years of school education, and birth in Germany.

Hypertension was associated with an 85-fold odds of a heart attack aged 45 or under. The corresponding odds of a premature heart attack associated with active smoking, diabetes mellitus, parental history and obesity (BMI 30 kg/m2 or above) were 12, 5, 3 and 2. Alcohol consumption was associated with a lower odds of heart attack at a young age with an odds ratio of 0.3.

Prof Wienbergen said: “Our study shows that smoking and metabolic factors, such as hypertension, diabetes and obesity, are strongly associated with an increased likelihood of premature acute myocardial infarction. A protective effect of moderate alcohol consumption has been described by other studies and is confirmed in the present analysis of young patients.”

He concluded: “Our study suggests that family history is not the only predisposing factor for early heart attacks. The findings add impetus to the argument that young people should be educated about why it is important to avoid smoking and have a healthy body weight.”

Source: European Society of Cardiology

Categories : Cardiovascular DiseaseTags :

Nine in Ten Hypertension Cases Need More Treatment

On By ModernMedia
Image by Hush Naidoo from Unsplash
Image by Hush Naidoo from Unsplash

A series of studies has shown that in most cases, hypertension is not being adequately treated.

Hypertension is the leading treatable cause of illness and death worldwide. More than a billion people are hypertensive, defined as having diastolic blood pressure (BP) with 140mmHg or higher, or diastolic blood pressure (DBP) 90 mmHg or higher. Fewer than half of people with hypertension are aware of their condition.

This condition increases the risk of several dangerous illnesses, such as myocardial infarction (MI) and stroke, and of dying prematurely. For some patient categories, the most advantageous BP levels in terms of avoiding MI and stroke are uncertain.

In one of the studies in his thesis at Sahlgrenska Academy, University of Gothenburg, specialist doctor Johan-Emil Bager investigated the link between BP levels and the risk of MI or stroke in 5041 older patients.with hypertension but no history of heart attacks or strokes.
Risk for MI or stroke was found to be some 40 percent lower for the patients with systolic blood pressure (SBP) below 130 mmHg, compared with those in the SBP 130–139 range. In the latter group, 5.2 percent of the patients experienced a heart attack or stroke during the follow-up period, compared with 3.4 percent of those in the lower SBP group.

This pattern was repeated in another study, which investigated the risk of haemorrhagic stroke at different levels of BP in 3972 patients with atrial fibrillation (AF). These patients were receiving treatment with blood-thinning drugs, such as Warfarin or Eliquis.

The study showed that patients with SBP ranging from 140 to 179 mmHg had a haemorrhagic stroke risk roughly double that of patients with SBP of 130–139 mmHg. In the patient group with higher SBP, 1.4 percent suffered a hemorrhagic stroke during the follow-up period, compared with 0.7 percent of patients in the group with lower SBP.

A separate study with data on 259 753 patients also demonstrated insufficiency of hypertension treatment. Nine out of ten patients had either insufficient BP control or high blood lipids (cholesterol), or were smokers.

Johan-Emil Bager at the University of Gothenburg, said: “This means that an overwhelming majority of the patients with high blood pressure are exposed to at least one important, modifiable risk factor for cardiovascular disease and premature death.”

He concluded that an unnecessarily high number of people in Sweden suffer MI or stroke, or die prematurely, because of insufficiently treated hypertension.

“Health professionals and patients with hypertension alike need to aim higher when it comes to treating high blood pressure. The vast majority of patients with hypertension could reduce their MI and stroke risk by lowering their BP and blood lipids with more drugs, or through lifestyle changes.”

Source: University of Gothenburg

Categories : Cardiovascular DiseaseTags :

ARB Has Slight Edge Over ACE Inhibitors for Hypertension Treatment

On By ModernMedia
Photo by Hush Naidoo on Unsplash

A huge multinational study found that while angiotensin-converting enzyme (ACE) inhibitors are just as effective as angiotensin receptor blockers (ARBs) for hypertension treatment, ARBs have slightly fewer side effects.

The study, led by researchers at Columbia University Vagelos College of Physicians and Surgeons and encompassing millions of electronic health records, is the largest to compare the safety and efficacy of these two types of drugs. The findings were published online in Hypertension.

“Physicians in the United States and Europe overwhelmingly prescribe ACE inhibitors, simply because the drugs have been around longer and tend to be less expensive than ARBs,” said senior study author George Hripcsak, MD, the Vivian Beaumont Allen Professor and chair of biomedical informatics at Columbia University Vagelos College of Physicians and Surgeons.

“But our study shows that ARBs are associated with fewer side effects than ACE inhibitors. The study focused on first-time users of these drugs. If you’re just starting drug therapy for hypertension, you might consider trying an ARB first. If you’re already taking an ACE inhibitor and you’re not having any side effects, there is nothing that we found that would indicate a need for a change.”

“U.S. and European hypertension guidelines list 30 medications from five different drug classes as possible choices, yet there are very few head-to-head studies to help physicians determine which ones are better,” Dr Hripcsak said. “In our research, we are trying to fill in this information gap with real-world observational data.”

ACE inhibitors and ARBs are among the choices, and they have a similar mechanism of action. Both reduce the risk of stroke and heart attacks, though it’s known that ACE inhibitors are associated with increased risk of cough and angioedema.

“We wanted to see if there were any surprises–were both drug classes equally effective, and were ARBs producing any unexpected side effects when used in the real world?” Hripcsak says. “We’re unlikely to see head-to-head clinical trials comparing the two since we are reasonably sure that both are effective.”

To tackle the problem, the researchers analysed insurance claims and electronic health records from approximately 3 million patients in Europe, Korea, and the United States who were starting antihypertensive treatment with either an ACE inhibitor or an ARB.

The researchers employed a variety of cutting-edge mathematical techniques to dramatically reduce the bias and deal with information gaps from electronic health records, balancing the two treatment groups as if they had been enrolled in a prospective study.

The researchers tracked four cardiovascular outcomes–heart attack, heart failure, stroke, and sudden cardiac death–and 51 adverse events in patients after they started antihypertensive treatment.

They found that the vast majority of patients–2.3 million–were prescribed an ACE inhibitor, but found no significant difference between the two drug classes in reducing major cardiovascular complications in people with hypertension. As expected, patients taking ACE inhibitors had a higher risk of cough and angioedema, but the risk of pancreatitis and gastrointestinal bleeding was slightly higher as well.

“Our study largely confirmed that both antihypertensive drug classes are similarly effective, though ARBs may be a little safer than ACE inhibitors,” Hripcsak said. “This provides that extra bit of evidence that may make physicians feel more comfortable about prescribing ARBs versus ACE inhibitors when initiating monotherapy for patients with hypertension. And it shows that large-scale observational studies such as this can offer important insight in choosing among different treatment options in the absence of large randomised clinical trials.”

Source: EurekAlert!

Categories : Cardiovascular DiseaseTags :

Do Heart Hormones Drive Nighttime Hypertension?

On By ModernMedia
Photo by Marcelo Leal on Unsplash

In a new series of studies, University of Alabama at Birmingham researchers have described the reasons behind low levels of natriuretic peptides (NPs) in obese individuals. 

First reported six decades ago, NPs are beneficial hormones produced by the heart, and are responsible for blood pressure regulation and the overall cardiovascular and metabolic health of humans. This study also addresses how the disturbance of an individual’s diurnal rhythm of these hormones contributes to poor cardiovascular health in obese individuals.

High blood pressure at nighttime is seen commonly in obese individuals, who already have higher risk of hypertension and poor cardiovascular outcomes. This can contribute to outcomes such as stroke, heart failure, heart attack and cardiac death. But why this impairment of this day-night blood pressure rhythm is not well understood — however, scientists believe that part of the reason lies with NPs.

“All the hormones in the human body have a day-night rhythm,” noted Vibhu Parcha, MD, a clinical research fellow in the Division of Cardiovascular Disease and the first author of both the studies. “It has been hypothesised the NP hormones should also have this rhythm, but this had not yet been demonstrated in humans. Our clinical trial assessed the 24-hour cycle of the NP hormones and compared it to the 24-hour cycle of blood pressure. We also studied how these cycles differ between lean and obese individuals and studied the reasoning behind why obese individuals experience lower levels of NPs.”

Following a rigorous clinical trial of healthy individuals, researchers found that NP hormones have a diurnal rhythm with higher levels in the afternoon and lower levels at nighttime — similar to the 24-hour cycle of blood pressure. In obese individuals however, researchers observed that the relationship between NPs and blood pressure does not function the same way. This leads to higher nighttime blood pressure and increased risk of cardiovascular disease. The low production of NPs combined with a relatively higher elimination of NPs from an obese individual’s system leads to low levels of these beneficial hormones in circulation, which may explain the NP deficiency.

“This is the first time we have seen that NPs, like other hormones, have a 24-hour rhythm,” said senior author Pankaj Arora, MD, a physician-scientist in UAB’s Division of Cardiovascular Disease. “These studies give us a better understanding of NPs and of the reasoning behind the NP deficiency in obese individuals. We now have an FDA-approved medication (LCZ696) that improves circulating NP levels. This medication is considered a first-line treatment for heart failure and may be used to increase NP levels.”

This medication could specifically target NPs and blood pressure if given at the right time of day and could control hypertension with precision, Dr Arora added. These findings point to using a physiologically-driven precision ‘chronopharmacotherapy’ approach to improve the diurnal blood pressure profile in obese individuals.

Source: University of Alabama at Birmingham

Journal information: Vibhu Parcha et al, Chronobiology of Natriuretic Peptides and Blood Pressure in Lean and Obese Individuals, Journal of the American College of Cardiology (2021). DOI: 10.1016/j.jacc.2021.03.291

Categories : Metabolic DisordersTags :

Zinc’s Surprising Role in Blood Pressure

On By ModernMedia
Source: Wikimedia CC0

Researchers have discovered that a trace element, zinc, plays a previously unknown role in the regulation of blood pressure.

While the role of metals like potassium and calcium have been long known in this process, a new discovery about zinc’s critical and underappreciated role offers a potential new pathway for therapies to treat hypertension. While hypertension had been known to be associated with low zinc levels, it was not clear as to why.

The findings were published recently in Nature Communications.

The smooth muscle cells lining blood vessels regulate the speed at which the blood travels around the body. As smooth muscles contract, they narrow the artery, increasing blood pressure, and as the muscle relaxes, the artery expands and blood pressure falls. Too low a blood pressure, and the blood flow will be insufficient to sustain body tissues. If blood pressure is too high, the blood vessels risk being damaged or even ruptured.

“Fundamental discoveries going back more than 60 years have established that the levels of the calcium and potassium in the muscle surrounding blood vessels control how they expand and contract,” said lead author Ashenafi Betrie, PhD, and senior authors Scott Ayton, PhD, and Christine Wright, PhD, of the Florey Institute of Neuroscience and Mental Health and The University of Melbourne in Australia.

Specifically, the researchers explained, potassium regulates calcium in the muscle, and calcium is known to induce the narrowing of the arteries and veins that elevate blood pressure and restrict blood flow. Other cells surrounding the blood vessel, including endothelial cells and sensory nerves, also regulate the calcium and potassium within the muscle of the artery, and are themselves regulated by the levels of these metals contained within them.

“Our discovery that zinc is also important was serendipitous because we’d been researching the brain, not blood pressure,” said Dr Betrie. “We were investigating the impact of zinc-based drugs on brain function in Alzheimer’s disease when we noticed a pronounced and unexpected decrease in blood pressure in mouse models treated with the drugs.”

The investigators discovered that coordinated action by zinc within sensory nerves, endothelial cells and the muscle of arteries triggers lower calcium levels in the muscle of the blood vessel. This causes the vessel to relax, decreasing blood pressure and increasing blood flow. The scientists found that the brain and heart’s blood vessels were more sensitive to zinc than blood vessels in other areas of the body, warranting further research.

“Essentially, zinc has the opposite effect to calcium on blood flow and pressure,” said Dr Ayton. “Zinc is an important metal ion in biology and, given that calcium and potassium are famous for controlling blood flow and pressure, it’s surprising that the role of zinc hasn’t previously been appreciated.”

This research also explains the fact that the genes that control intracellular zinc levels are known to be associated with cardiovascular diseases including hypertension, and hypertension is also a known side effect of zinc deficiency.

“While there are a range of existing drugs that are available to lower blood pressure, many people develop resistance to them,” said Dr Wright, who added that a number of cardiovascular diseases, including pulmonary hypertension, are poorly treated by currently available therapies. “New zinc-based blood pressure drugs would be a huge outcome for an accidental discovery, reminding us that in research, it isn’t just about looking for something specific, but also about just looking.”

Source: Medical Xpress

Categories : Gender Neurodegenerative DiseasesTags :

High Blood Pressure Dementia Risk Found for Women

On By ModernMedia
Image by Steve Buissinne from Pixabay

Differences in blood pressure’s influence on dementia risk in men and women may provide clues to help slow the rapid progress of the disease, according to new research.

In a study involving half a million people, researchers found that although the link between several mid-life cardiovascular risk factors and dementia was similar for both sexes, for blood pressure it was not. Low and high blood pressure were both shown to be associated with a greater risk of dementia in men, but for women the risk of dementia increased as blood pressure went up.

Lead author Jessica Gong said that while more research was needed to verify these findings, they may point to better ways of managing risk.

“Our results suggest a more tailored approach to treating high blood pressure could be more effective at preventing future cases of dementia,” she said.

Dementia is fast becoming a global epidemic, currently affecting an estimated 50 million people worldwide. This is projected to triple by 2050 – mainly driven by aging populations. Rates of dementia and associated deaths are both known to be higher in women than men.

In 2016 it overtook heart disease as the leading cause of death in Australian women and it is the second leading cause of death for all Australians.

With no treatment breakthroughs of any significance, the focus has therefore been on cutting the risk of developing the disease. Cardiovascular risk factors are increasingly recognised as contributors to different types of dementia.

To explore differences in major cardiovascular risk factors for dementia between the sexes, George Institute researchers accessed data from the UK Biobank, a large-scale biomedical database that recruited 502 489 dementia-free Britons 40-69 years old between 2006 and 2010.

They found that, to a similar degree in women and men, smoking , diabetes, high body fat levels, prior stroke history, and low socio-economic status were all linked to a greater risk of dementia.

But when it came to blood pressure, the relationship with dementia risk between the sexes was different. Although the reason for this wasn’t clear, the authors proposed some possible explanations.

“Biological differences between women and men may account for the sex differences we saw in the relationship between blood pressure and the risk of dementia,” said Ms Gong.

“But there may also be differences in medical treatment for hypertension. For example, women are less likely to take medication as prescribed by their healthcare provider than men and may be taking more medications and experiencing more side effects.”

While there are no effective treatments for dementia, trying to reduce the burden of the disease by encouraging healthier lifestyles is the priority, and the strongest evidence points to blood pressure management.

“Our study suggests that a more individualised approach to treating blood pressure in men compared to women may result in even greater protection against the development of dementia,” said study co-author Professor Mark Woodward.

“It also shows the importance of ensuring sufficient numbers of women and men are recruited into studies and that the data for women and men should be analysed separately,” he added.

Source: George Institute