Automated telephone reminders pay off for blood pressure patients: study

From CBC News:
Automated telephone call reminders helped people with high blood pressure to lower their readings compared with people who did not receive the calls, researchers in Montreal found.

In the one-year study to be published in the journal Circulation: Cardiovascular Quality and Outcomes, 223 patients with hypertension were randomly assigned to receive calls from a computer-based system at least once a week with high readings sent to their doctors or receive an educational booklet and usual medical care.

"Forty-six per cent were controlled, achieved the target, versus 28 per cent without the system," senior author Dr. Pavel Hamet, a professor of medicine, physiology and nutrition at the University of Montreal, said Tuesday.

The improvement was "highly significant," and the system worked as well as adding a new medication, Hamet said. ...more

Changing habits may not lower blood pressure

From Reuters:
People who say they are making lifestyle changes in addition to taking medication to reduce high blood pressure may actually be less likely to have their blood pressure under control than people relying on drugs alone, new research from Canada shows.

"Whether we like it or not, the only thing which we can definitely offer which really works is drug treatment," Dr. George J. Fodor of the University of Ottawa Heart Institute in Ontario told Reuters Health. "I don't like it and most people don't like it, but this is the simple truth."

Exercise, weight loss and other lifestyle modifications are widely recommended as the first line of treatment for people recently diagnosed with hypertension. While clinical trials have shown that these measures are effective, there is less information on how readily people make these changes in real life, and how effective they are outside the clinical trial setting. ...more

Pharmacists' care drops blood pressure: study

From the Edmonton Journal:
Patients with high blood pressure who received enhanced care from pharmacists saw their blood pressure go down more than patients who received normal care from their pharmacists and family doctors, a new study has found.

The drop reduces a patient's risk for stroke by 30 per cent and risk of heart attack by 23 per cent, as long as the patient maintains the lowered blood pressure long-term, said Dr. Ross Tsuyuki, a pharmacist and the senior author of a paper published Monday in the journal, Archives of Internal Medicine.

"That's what we were really excited about -- a 30-per-cent reduction in stroke is quite a bit," Tsuyuki said.

He enlisted the help of pharmacists in 14 Medicine Shoppe pharmacies in urban Edmonton, Mill Woods, Sherwood Park and Spruce Grove, who identified 227 diabetic patients whose blood pressure was above the recommended 130/80 millimetres of mercury for diabetics. High blood pressure is anything above 140/90. ...more

Drug May Lower Blood Pressure in Adolescents With Hypertension

I've never heard of anyone trying to lower uric acid levels to control hypertension before this article. I find this to be a fascinating new approach. This reminds me of the then-radical theory that ulcers can be caused by bacteria and can be treated with antibiotics - a totally new approach. Credit to Corey Nahman for finding this one.

From the Washington Post:
The drug allopurinol -- a drug used to lower uric acid levels -- may lower blood pressure in adolescents with high blood pressure, a new study shows.

Because high blood pressure is commonly associated with high uric acid levels, some studies suggest that elevated uric acid may be one cause of high blood pressure. But since elevated uric acid levels in high blood pressure could be the result of several factors, high uric acid levels are not currently considered a true risk factor for hypertension.

The current study, published in the Aug. 27 issue of the Journal of the American Medical Association, tested whether treatment with allopurinol would reduce blood pressure in 30 11- to 17-year-olds who had high uric acid levels and newly diagnosed high blood pressure. ...more

Managing hypertension at home improves results

From the Chicago Daily Herald:
Patients with high blood pressure controlled the condition better using in-home testing and Internet consultations with a pharmacist than by working with their doctors alone, researchers found.

Almost twice as many patients who relied on testing and the pharmacist to help guide their therapy, in addition to their usual care managed their blood pressure compared with those who only worked with their doctors, according to a study in the Journal of the American Medical Association.

About one in three U.S. adults have been diagnosed with high blood pressure and less than half have the condition under control, according to the researchers. Doctors are searching for new ways for patients to control their hypertension, which can lead to stroke, heart attacks, heart failure and kidney disease if untreated. ...more

MDs marvel at blood pressure drug combo

From the Toronto Star:
An international drug trial that could change the way high blood pressure is controlled has shown a combination of two common hypertension medications can bring the often-lethal condition under control, even in the most dangerous cases.

In the trial, which was stopped early because the results were so positive, researchers found patients who took a so-called ACE-inhibitor and CCB combination pill suffered 20 per cent fewer major cardiac events, including death from heart attack and stroke.

The drug combination also effectively controlled blood pressure levels for 80 per cent of patients with the most serious hypertensions.

The interim results, which doctors say should "shake the foundations" of current treatment, were presented yesterday at a meeting of the American College of Cardiology in Chicago.

Study leader Dr. Kenneth Jamerson, professor of internal medicine at the University of Michigan, said an independent monitoring board recommended ending the trial after only 60 per cent of the data had been collected because the results were so conclusive and could potentially benefit millions of patients. ...more

ACE Inhibitor as Effective as More Expensive Blood Pressure Drug

From U.S. News and World Report:
Treatment with an ACE inhibitor drug was as effective in reducing deaths, heart attacks and stroke in a high-risk group of patients as a newer and more expensive angiotensin-receptor blocker (ARB) drug, a large international study has found.

The study of more than 17,000 people with coronary artery disease or diabetes found no major differences between those treated with the widely used ACE inhibitor ramipril (Altace) and those given the ARB telmisartan (Micardis).

"This is the first study in such a population that shows ACE inhibitors are as effective as ARBs," said study leader Dr. Salim Yusuf, a professor of medicine at McMaster University, in Hamilton, Ontario, Canada. ...more

Study: Timing of Pills Might Matter

From Newsday (NY):
Taking a blood pressure pill at bedtime instead of in the morning might be healthier for some high-risk people.

New research suggests that simple switch may normalize patterns of blood pressure in patients at extra risk from the twin epidemics of heart and kidney disease.

Why? When it comes to blood pressure, you want to be a dipper. In healthy people, blood pressure dips at night, by 10 to 20 percent. Scientists don't know why, but suspect the drop gives arteries a little rest.

People with high blood pressure that doesn't dip at night -- the non-dippers -- fare worse than other hypertension sufferers, developing more serious heart disease. Moreover, heart and kidney disease fuel each other -- and the 26 million Americans with chronic kidney disease seem most prone to non-dipping. In addition to heart problems, they're at extra risk of their kidney damage worsening to the point of dialysis. ...more

1 in 4 patients prescribed unproven drug mix

When I see this article, it screams out at me: a lot of physicians aren't treating their patients optimally because they are not up to date on the latest regimens. Sounds like they might benefit by collaborating closer with a pharmacist...

From the Globe and Mail:
Patients with high blood pressure are increasingly being treated with powerful combinations of drugs.

And according to a new Canadian study, one in four patients are being prescribed unproven - and probably ineffective - combinations by their doctors.

"It's a good thing that there's more polytherapy," Karen Tu, a scientist at the Toronto-based Institute for Clinical Evaluative Sciences and co-author of the study, said in interview.

"[But] unfortunately, it appears that not all physicians are completely aware of the drug combinations that work best for their patients."

The research, published in today's edition of the Canadian Journal of Cardiology, sheds light on treatment for hypertension, a critical but rapidly changing field of medicine. ...more