Society – High Blood Pressure: Not everyone’s drugs interfere

Published on 11/2022 – Published on June 14, 2022

Bolzano / Vinschgau – Many older people swallow one or more blood pressure tablets with morning coffee. But pills don’t always work. Data from the CHRIS study, the Eurac Research population study and the South Tyrolean Medical Society now form a valuable basis for examining why high blood pressure therapies do not work for some people. For example, the research team working on the HyperProfile study uses biomarkers to measure the effectiveness of certain drugs in one of the biological processes that control high blood pressure. The responsible researcher is biologist Luisa Foco from the Institute of Biomedicine Eurac Research.

Winch: Does it often happen that therapies against high blood pressure do not work?

Louise Focus: Of the people who participated in the first phase of the CHRIS study, high blood pressure was already treated in 1814. However, in about half of the cases, blood pressure was not under control. In some cases, drug therapy can be adjusted even better, in others we can talk about real resistance. High blood pressure is often due to medication indiscipline and poor lifestyle, but there is also a significant proportion of people who are not treated for high blood pressure medications.

What are the most commonly used drugs?

One of the most common combinations currently used for high blood pressure is a combination of three: an ACE inhibitor or sartan, a diuretic, and a calcium channel blocker. About 30 percent of CHRIS participants with high blood pressure take ACE inhibitors or sartans, and another 18.5 percent also take diuretics. 154 people were prescribed the most commonly used combination. We talk about people who take at least three pills a day – and in spite of everything, 87 of them, more than 56 percent, still have high blood pressure.

Why is that?

To understand why drugs cannot regulate blood pressure, the first step is to examine what is happening at the molecular level in people who do not respond to therapy. Blood pressure control is like watching a movie involving countless actors, starring the so-called “renin-angiotensin-aldosterone system” (RAAS for short). The main antihypertensives affect this system.

How does the data from the CHRIS study contribute to this research?

For each CHRIS participant profile, we examine six biomarkers that show how this RAAS process works. It has been confirmed that drugs work, but also that they are not always effective. For example, there are people who have much higher adrenal activity than you might expect because they take drugs that inhibit the production of a hormone called aldosterone. This could indicate that high blood pressure is the result of another disease, primary aldosteronism. In this case, blood pressure can be controlled simply by changing medication. In general, the markers we study can help doctors choose the best therapy.

Study

Research partners include the Eurac Research Institute for Biomedicine, the University of Glasgow, the French Inserm Research Institute and Schlanders Hospital. In particular, Dr. Stefano Barolo, head of the Ambulance for Arterial Hypertension and Cardiovascular Risk, studies and warns: “In Italy, one in three people suffers from so-called hypertension. This number will increase in the future due to the aging of the population. Because the elasticity of the arterial walls decreases with age, which leads to an increase in systolic blood pressure. Angiotensin-aldosterone system.

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