High Blood Pressure Blog

A common drug used to treat people suffering from gout might be the next big thing in treating teenagers with high blood pressure, according to data from a a new study.

The study, published by researchers from Baylor University and appearing in the new issue of the Journal of the American Medical Association, examined how certain types of teenagers responded when treated with the drug allopurinol. Allopurinal is designed to reduce blood levels of a substance called uric acid. It is commonly used to treat gout, since elevated uric acid is the primary cause of the painful disease.

Earlier research has shown that some teens with high blood pressure have unexplained increases in their uric acid levels, leading the authors of the current study to suggest that drugs designed to reduce uric acid might have some benefit in treating high blood pressure in these specific patients. This theory was bold, because scientists were unsure whether the high blood pressure was casuing the increase in uric acid, or whether the increased uric acid was causing changes leading to high blood pressure.

Patients in the study group - who all had elevated uric acid levels - showed greater reductions in blood pressure when treated with allopurinol in addition to normal high blood pressure medicines. The patients on both medicines had larger overall drops in blood pressure than patients only receiving traditional treatments.

This research is a potential breakthrough in treating certain types of high blood pressure that are usually difficult to control. The authors caution, though, that allopurinol can be a dangerous drug and that traditional treatment - along with lifestyle changes - is still the most effective treatment for most patients

As the worsening economy puts increasing strain on people's pocketbooks, tough economic times may actually have overall health benefits. According to a recent article in the Los Angeles Times, researchers have found that tough economic periods seem to correspond to a decrease in deaths from diseases and conditions that are sensitive to lifestyle choices.

Deaths from high blood pressure, heart disease, and even car crashes fall as people worried about the economy eat, smoke, and drive less.

After examining a wealth of data from the United States and 23 developing nations, economics professor Christopher J. Ruhm, Ph.D., of the University of North Carolina, found that "deaths, overall...decrease when times turn bad." Ruhm argues that "the more that a cause of death affects primarily young people, the greater the effect of a shifting economy."

A research team from the Harvard Medical School is working to detail the complicated relationship between migraine headaches and heart disease in women, and has published their most recent findings in the journal Neurology.

In the study, investigators looked at the links between genetics, migraine headaches, and cardiovascular disease. People who suffer from migraine headaches fall into one of two groups - those who have "aura" symptoms before getting a headache and those who develop headaches without any preceeding aura symptoms. Now, the Harvard team thinks that auras, along with certain genetic markers, may indicate certain types of risk for heart disease and stroke.

About 11 percent of patients in the study had a specific type of genetic variant thought to be the critical link between migraines with aura and an increased risk of stroke. When examined further, the researchers found that this gene variant by itself does not seem to increase the risk of heart disease, as once thought. Similarly, people with the gene variant, who also have migraines do not appear to have any increased cardiovascular risk, but may be at increased risk of having a stroke. However, patients who have migraines preceeded by aura symptoms combined with this gene variation do seem to exhibit an increased level of developing cardiovascular disease.

The reasons for this are not yet clear, and are the focus of ongoing research. Dr. Tobias Kurth, one of the study authors, says that "while it is too early to start testing young women with migraine(s)...for this gene variant, more focused research...will help us to potentially develop preventative strategies."

Hard economic times are starting to impact health care, according to a recent article in the Wall Street Journal. Already feeling the pinch at the gas pump and grocery store, a growing number of people are facing hard choices when it comes to their health. More people are delaying health care that is seen as "non-critical" and adjusting - or stopping - their medications because of an inability to shoulder the extra cost. The result? Patients are showing up sicker in doctor's offices and emergency rooms. That, though, has the opposite financical effect, as urgent care and emergenc room treatment is often significantly more expensive than the monthly cost of medications and office visits, even for those with little or no insurance.

While those with insurance might pay up to $30 or $40 for prescription medications - potentially up to $100 or more for those without insurance drug coverge - and a similar amount for office visits (an average of $165 for those with no insurance), a trip to the emergency room can easily run into the thousands of dollars.

Data shows that insurance companies are feeling the pinch, too. The severity and cost of claims has risen across the board this year, one of the first increases of this type in recent history.

On the patient side, medication compliance, preventative care, and elective procedures are all showing reductions.

In a new publication, the American Heart Association (AHA) has issued new stroke guidelines to doctors on how to diagnose and properly treat stroke in children. In the new bulletin, the AHA states that strokes are more common in children than many doctor's realize, and that the symptoms and complication risks are markedly different from adults.

One of the biggest differences is that drugs used to dissolve clots in older patients are generally not recommended for children. In fact, while treatment pathways for adults are fairly clear and well laid out, there is no single, uniform approach for treating children. The authors of the guidelines note that this is because of the vast differences present in pediatric stroke victims. While adults with stroke tend to have similar problems and underlying disorders, this is not the case in younger patients, who may develop stroke for a variety of unrelated reasons.

While the guidelines encouragingly note that doctors have gotten much better at diagnosing and treating stroke in children - due largely to technological advances like advanced magnetic resonance imaging and magnetic resonance angiography - they still need to focus treatment efforts on the right targets. In children, the primary focus of stroke treatment is preventing lasting neurological problems and avoiding future strokes.

There has been speculation that the rising incidence of both obestity and high blood pressure may be partially to blame for the increasing number of children who suffer stroke.

The Centers for Disease Control (CDC) on Thursday released a new study showing that despite declines, most Americans still have measurable exposure to second hand smoke.

The study, which included children as young as 4 years old, looked at the amount of cotinine - a nicotine byproduct - in the blood of non-smokers. While the amount of this chemical in non-smokers fell by about 70% since the last time the CDC conducted this research in the 1980s and 90s, it was still measurable and "significant."

CDC officials cite recent smoking bans in restaurants and other public spaces as an important contributor to the decline noted in the study, but reaffirm that the presence of cotinine in any amount means that non-smokers are being exposed to measurable health effects from second hand smoke.

The study authors note that children are still the most at risk and are more likely than adults to be exposed at home.

Smoking has been linked to a number of serious health problems, including high blood pressure, and evidence suggests that non-smokers are still at increased risk for these problems when exposed to second hand smoke.

Acute Coronary Syndrome (ACS) is a common disease in people with high blood pressure, and can lead to heart attack or other serious problems. In general, ACS indicates that some of the blood vessels supplying the heart with blood have become partially blocked. Traditionally, treatment options for ACS have included both medical treatment (reducing the blockages with medicines) and surgical options (angioplasty, stenting, bypass surgery)

A new study published in the Journal of the American Medical Association suggests that gender may be an important factor when deciding which type of treatment to choose.

Researchers from Harvard University, led by Dr. Michelle O'Donoghue, recently conducted a special type of study, called a meta analysis, examining how well different treatment options worked for treating ACS. In a meta study, researchers look at a large number of studies that have already been done on a particular subject and analyze all of the results together. Using statistical tools, they are able to answer questions that none of the individual studies could have.

In this meta analysis, the doctors looked at studies tracking how well patients with ACS did after receiving either medical or surgical treatment. The analysis unexpectedly revealed that while men tend to have benefits from a surgical intervention, women only benefit from surgery if their ACS is severe.

In women with early ACS, medical management is just as effective as surgery. When this finding is taken in context with the idea that other risks are involved in any surgical procedure, the result is that women with early ACS may actually be harmed by surgical treatment options compared to using medicines. This is not the case in men, who show benefits from surgical options. In cases of severe ACS, both genders appear to benefit from surgery.

These results are among a growing branch of scientific studies showing unexpected differences in heart disease between women and men.

The results of a small study showing that using two hormones - vasopressin and epinephrine - to treat people in the immediate aftermath of a serious heart attck improved survival rates for patients have been contradicted by a new, larger study examining the same question. The new study, conducted over a longer period of time, and on a much larger group of patients, shows that the standard therapy - using just epinephrine - is just as effective as using the combination of drugs.

The new study, published in the New England Journal of Medicine, tested the combination therapy vs standard therapy on almost 3,000 patients. Half received the ephinephrine/vasopressin combination and half received epinephrine only. After analzying the data, researchers found that survival rates, length of time to hospital discharge, and rate of neurologic recovery were similar in both groups of patients.

Interestingly, though the study revealed no difference between between the two treatment groups, it is being continued for the full scheduled length of time because doctors discovered an unexpected benefit - patients involved in the study seem to receive care more quickly, which does impact the chance of survival.

Data recently published by the Centers for Disease Control (CDC) shows that the smoking rate among teenagers has reached a plateau after falling for three consecutive years.

The CDC's Youth Risk Behavior Survey, which tracks the rate of smoking, drinking, drug use, and other risky behaviors among teenagers, showed that the number of teens who smoke cigarettes rose from 21.9% in 2003 to 23% in 2005, but then began to fall, reaching 20% in 2007. The decline is largely attributed to increased attention to the problem, which resulted in mandatory anti-smoking advertisements by tobacco companies and a variety of anti-smoking programs and materials, aimed at young people, produced by the CDC and other federal agencies.

The recent plateau coincides with both an increase in yearly pro-tobacco advertising from cigarette companies (which increased by almost a billion dollars per year from 1998 through 2005) along with a 28% decline in the amount of money spent by states on anti-smoking campaigns.

Terry Pechacek, a CDC spokeswoman, says, "This is the most dramatic indication that the great progress we're making has stalled," and it "has very negative long-term implications."

Smoking, along with obesity, is a leading preventable cause of hypertension, especially in young adults.

In a front page story, the Wall Street Journal notes a major decline in the number of new drugs being produced by large pharmaceutical companies. Industry spokesmen confirm that the number of "large scale projects" has been cut dramatically in recent months because of rising scrutiny from Food and Drug Administration (FDA) regulators.

In the aftermath of several headline grabbing medication related stories - some invovling numerous patient deaths - and incidents of medication contamination, the agency has taken steps to step up how strictly it scrutinizes new drug candidates.

One drug company CEO notes that the FDAs increasing focus on safety and decreasing tolerance of side effects has dramatically cut the odds that many large drug projects will produce any products that ultimately make it to market. As a result, those projects have been halted.

Dr. Janet Woodcock, director of the FDA's Center for Drug Evaluation and Research "denies that the agency has become 'more conservative' about drug safety," but acknowledges that last year, "the FDA approved just 19 new medicines, the fewest in 24 years, and announced about 75 new or revised 'black-box' warnings about potential side effects,...twice the number in 2004."