Hypertension, or high blood pressure, is referred to by the World Health Organisation as one of the world’s biggest silent killers because most people who have it can’t feel or see it. It affects around one in three people worldwide and can cause stroke, heart attacks and kidney failure. After diagnosis, treatment of high blood pressure needs to be lifelong and many patients are able to manage their condition with anti-hypertension drugs. But experts say that for around 1 in 50 of them, medication does not help. Julian Paton, who led this latest study at Bristol’s school of physiology and pharmacology, said while scientists already knew of a link between the carotid organs and hypertension, until now they “had absolutely no idea that they contributed so massively to the generation of high blood pressure.” Tim Chico, as consultant cardiologist at the University of Sheffield who was not directly involved in the research, described the technique as “exciting and innovative” but cautioned that more work was needed to assess its effectiveness and safety before it could be considered for use in patients. Normally, Paton explained, the carotid body acts to regulate the amount of oxygen and carbon dioxide in the blood. It is stimulated when oxygen levels fall in the blood – such as when someone is holding their breath.
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Removing of carotid body appears to be effective for high blood pressure
But, only 46 percent of them were aware of the diagnosis. Of those who were aware they had high blood pressure, nearly 90 percent were undergoing treatment, with about 30 percent taking two or more types of blood-pressure lowering medications. However, only a minority of those getting treated had their blood pressure under control. That finding was worst in people living in low-income countries, but was also significant in the middle and higher-income areas also studied. Blood pressure pills tied to breast cancer risk “Blood pressure lowering drugs are generally inexpensive and commonly available treatments,” said Yusuf. “However only a third of patients commenced on treatment are on enough treatment to control their blood pressure.” Yusuf said earlier use of combination therapies involving two or more types of blood-pressure lowering treatments may be required.
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Half of those with high blood pressure don’t know it
“It doesn’t present with symptoms.” As well, doctors need to learn how to properly treat hypertension. Too many give patients a single medication when using lower doses of several drugs at once has proven more effective. “This has been known for 20 years, but it hasn’t got through to physicians,” said Yusuf. “In a rich country like Canada, it’s that physicians aren’t as aggressive as they ought to be.” The results were alarming, even to a leading Ontario heart researcher. “I was struck by how poorly we’re doing,” said Dr. Jack Tu, head of the cardiovascular research program at the Institute for Clinical and Evaluative Sciences and a cardiologist at Toronto’s Sunnybrook Hospital. “The numbers were pretty bad.
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Half of those with high blood pressure don’t realize it, study says
This response comes about through a nervous connection between the carotid body and the brain. Professor Paton commented: “Despite its small size the carotid body has the highest blood flow of any organ in the body. Its influence on blood pressure likely reflects the priority of protecting the brain with enough blood flow.” The team’s work on carotid body research started in the late 1990’s and their recent discovery has since led to a human clinical trial at the Bristol Heart Institute of which the results are expected at the end of the year. Professor Paton added: “This is an extremely proud moment for my research team as it is rare that this type of research can so quickly fuel a human clinical trial. I am delighted that Bristol was chosen as a site for this important trial.” Professor Jeremy Pearson, Associate Medical Director at the BHF, which part-funded the research, said: “For around one in fifty people with high blood pressure, taking pills does not help their condition. This research, in rats, has found that blocking special nerve endings in the neck significantly reduces blood pressure.
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