‘smarter’ Blood Pressure Guidelines Could Prevent Many More Heart Attacks And Strokes

Current medical guidelines use a one-size-fits-all treatment approach based on target blood pressure values that leads to some patients being on too many medications and others being on too little, authors say. Blood pressure medication is ultimately used to prevent associated heart disease and stroke. Researchers found that a person’s blood pressure level is often not the most important factor in determining if a blood pressure medication will prevent these diseases but common practice is to base treatment strictly on blood pressure levels. “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,” says lead author Jeremy Sussman, M.D., M.Sc., assistant professor of internal medicine in the Division of General Medicine at the U-M Medical School and research scientist at the Center for Clinical Management Research at the VA Ann Arbor Healthcare System. “The purpose of these medications is not actually to avoid high blood pressure itself but to stop heart attacks, strokes and other cardiovascular diseases. 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.
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New procedure to revolutionise blood pressure treatment

That study, conducted by centers in Ireland, Scotland and the Netherlands, looked at whether lowering cholesterol protected people at risk for heart disease. Over three years of follow-up, participants’ blood pressure was checked every three months. Researchers looked at the variability in those readings and tested participants’ mental functioning. Specific tests evaluated attention, reaction time and memory. Mooijaart’s team found that people whose blood pressure varied from visit to visit performed worse on all of the tests than those with stable readings. These results persisted after the researchers accounted for cardiovascular disease and average blood pressure.
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The study, conducted in Australia and Europe, found that the initial reports of a six-month blood pressure lowering benefit in this group of patients, who have treatment resistant hypertension, are sustained out to three years. Director of Monash University’s Centre of Cardiovascular Research and Education in Therapeutics, Professor Henry Krum, led the research collaboration around this study. The new technique, called percutaneous renal sympathetic denervation, involves disrupting the nerves around the kidney that sends signals to the brain and kidneys to drive up blood pressure. There were no major short or long-term safety issues associated with the procedure. The World Health Organisation estimates that hypertension affects around 40 per cent of adults aged 25 and over and is responsible for 7.5 million deaths a year worldwide. It is a risk factor for heart disease – the leading cause of death in Australia – and a number of other conditions including, stroke, heart failure, renal impairment and visual impairment.
For the original version including any supplementary images or video, visit http://medicalxpress.com/news/2013-11-procedure-revolutionise-blood-pressure-treatment.html

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