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Early blood pressure treatment may postpone true hypertension

had developed hypertension, compared with 53 percent of the participants who received candesartan for two years followed by placebo for two years. There was no difference between the groups in adverse events, serious or otherwise, suggesting no side effects from the drug.

Julius and his colleagues emphasize that the study addresses one of hypertension's most insidious characteristics: the rapid pace at which it develops and worsens, setting individuals up for heart disease and stroke.

"Rising blood pressure is not a linear process. It goes exponentially, and as blood vessels start to respond to higher pressure, they develop hypertrophy, which causes further aggravation of hypertension," Julius explains. "The concept behind this study, based on a phenomenon observed in animal studies, is that by preventing the escalating effect on the blood vessels, one can interrupt the process of hypertension."

The need for better strategies for pre-hypertensive people is urgent, Julius adds. "What we have done so far is tell them to exercise and watch their diet, but these measures have not had any impact on public health. Rates of pre-hypertension are actually increasing," he says. "The time has come to look at this problem in a new way, and that is what this study set out to do. It's not the answer for everything, but it looks pretty promising, though one would like to see stronger results."

Now, the researchers say, more studies of pre-hypertension are needed, to complement the large amount of research on end-stage hypertension that has been carried out in recent years.

According to the American Heart Association, high blood pressure was listed as a primary or contributing cause of death in about 277,000 American deaths in the year 2003. About 69 percent of people who have a first heart attack, 77 percent of those who have a first stroke, and 74 percent of patients with heart failure have blood pressure higher than 140/90 mmHg.


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Contact: Kara Gavin
kegavin@umich.edu
734-764-2220
University of Michigan Health System
14-Mar-2006


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