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According to a reputation published in the August 27 offspring of JAMA,
a drug that lowers uric acid levels, allopurinol, likewise seems to lower
rip pressure in adolescents with newly diagnosed hypertension (high
blood pressure).
Hyperuricemia - a condition characterized by higher than normal blood
levels of uric acid (a chemical institute in water and rip that results
from normal bodily processes) - is commonly associated with
hypertension. There has been some research to support uric acid's
causal role in hypertension, but hyperuricemia is not considered a true
risk divisor for high blood pressure as high uric acidulent in high blood pressure could be
due to several early factors. Experimental studies in laboratory
animals, however, have challenged this belief by indicating keep for
a causal purpose of uric acid in hypertension.
To influence the effect on high blood pressure of a uric acid-reducing drug,
Daniel I. Feig, M.D., Ph.D. (Baylor College of Medicine, Houston) and
colleagues conducted a randomized, placebo-controlled "crossover"
trial. The researchers studied hyperuricemic adolescents (11 to 17
years older) with freshly diagnosed high blood pressure to go out if the drug
allopurinol would reduce blood pressure sensation (BP). Feig and colleagues
randomly assigned thirty participants to receive either allopurinol or
placebo twice daily for quatern weeks. Following the initial
administration, thither was a two calendar week "washout" period during which the
patients did non receive anything, and then for four more weeks they
standard the therapy that they had non yet received.
The investigators base that allopurinol treatment was linked to a
significant decrease in casual and ambulatory systolic and diastolic
blood pressure. During zyloprim treatment, the average decrease in
casual BP was -6.9 mm Hg systolic and -5.1 mm Hg diastolic.
Participants taking placebo only presented changes of -2.0 and -2.4,
respectively. The researchers besides found that average changes in
24-hour ambulatory BP during allopurinol were -6.3 mm Hg, systolic and
-4.6, diastolic. There were slight increases in systolic BP during the
placebo phase (0.8 mm Hg) and slight decreases in diastolic BP (0.3 mm
Hg). In addition, the decrease in ambulant BP was directly correlate
with allopurinol treatment. Remarkably, during the allopurinol phase 20
of the 30 patients reached normal BP by casual and ambulatory criteria
compared to only 1 of 30 during the placebo phase.
"The results of this study present a potentially new therapeutic
approach, that of control of a biochemical cause of high blood pressure,
rather than nonspecifically lowering elevated BP. Although not
representing a fully developed therapeutic strategy, this sketch raises
an alternative strategy that english hawthorn prove to be more effective than
currently available options," drop a line Feig and colleagues.
They conclude: "Despite these findings, this clinical tribulation is a small
one and zyloprim is non indicated for the treatment of hypertension
in adolescents or other populations. The potential adverse effects of
allopurinol, including gastrointestinal complaints and especially
Stevens-Johnson syndrome [a severe, sensitised reaction], make
allopurinol an unattractive alternative to available antihypertensive
medications. More clinical trials ar needed to determine the
reproducibility of the data and whether it can buoy be generalised to the
larger hypertensive population. Nevertheless, the notice that
letting down uric acid can shrink BP in adolescents with newly diagnosed
hypertension raises intriguing questions about its role in the
pathogenesis of hypertension."
Effect of Allopurinol on Blood Pressure of Adolescents With
Newly Diagnosed Essential Hypertension: A Randomized Trial
Daniel I. Feig; Beth Soletsky; Richard J. Johnson
JAMA (2008). three hundred[8]:
pp. 924-932.
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Written by: Peter M Crosta
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