A new study published in the Journal of Clinical Hypertension supports a strategy designed to lower blood pressure. Scientists from Barts Health NHS Trust and Queen Mary University of London say they were able to successfully improve blood pressure control among patients with severe intolerance to antihypertensive medication. They did so by using medicines in unconventional ways and treating patients with a stepped care approach where the most effective but least intensive treatment is delivered to patients first.
The study involved 55 people that received fractional dosing with tablets in which the pills were halved or quartered as well as liquid formulations of antihypersensitive drugs with patch formulations of antihypertensive drugs and the use of unlicensed drugs that lower blood pressure.
- The patients experienced no debilitating side effects.
- The results were sustained.
- Blood pressure was significantly reduced among patients after just six months on the treatment strategy.
This is an entirely new concept in tackling high blood pressure, said Dr. Melvin Lobo, who led the study at Queen Mary University of London and is also Director of the Barts Health Blood Pressure Clinic. There has in the past been an emphasis and even a blame culture on proving that uncontrolled blood pressure is down to patients either forgetting or not wanting to take their tablets. Many of our patients have reported negative experiences with their doctors after complaining about drug side effects. Often the feeling is that reducing the health risks of patients with high blood pressure, such as stroke or heart attack, justifies the very serious drug intolerance that they can experience. We, however, took a different view. We understand that some patients feel forced to cease their treatment due to how wretched it makes them feel. And so we set about trying to help them get around side effects, as opposed to forcing them to take drugs they felt were poisoning them. Some patients have even contemplated suicide rather than continue with medications that cause severe adverse effects - that is how serious this issue is."
There are approximately 15 million individuals in the United Kingdom with high blood pressure.
Around half of the patients with hypertension stop taking their medication within 12 months of being prescribed antihypertensive drugs.
Severe intolerance is found in 10 percent of patients referred to the Barts Health Blood Pressure Clinic.
"Blood pressure control is vital as a means of avoiding serious cardiovascular events such as heart attack and stroke, Lobo added. However, anti-hypertensive medication side effects are common and can be very debilitating, causing severe impact on quality of life. Patients should not have to suffer such side effects when there are alternative ways of treating them. We also urge clinicians to be more sympathetic towards their patients who report drug side effects. After all, high blood pressure is an asymptomatic condition and it is the drugs that can make patients symptomatic with adverse effects. For this our patients should not be culpable. We recommend people with intolerance to three or more high blood pressure drugs, who are struggling to control their blood pressure, be referred to our center at Barts Health NHS Trust. We plan to extend our studies into primary care in order to widen our reach and broaden the impact of our findings."
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