Guideline alert for blood pressure patients as treatment combo fails



    TORONTO, Jan. 16 /CNW/ - Thousands of Canadians with high blood pressure
(hypertension) are being treated with a drug combination that increases the
risk of sudden cardiac death, kidney disease and the likelihood of dialysis,
warns the Heart and Stroke Foundation.
    New guidelines from Canadian Hypertension Education Program (CHEP) based
on international research funded in part by the Foundation will urge patients
who have been prescribed a combination of ACE inhibitors and Angiotensin II
Receptor Blockers (ARBs) to see their family physicians as soon as possible
for a treatment change.
    "These two popular categories of hypertension medication are each safe
and effective treatments - but not together," says Dr. Sheldon Tobe,
spokesperson for the Heart and Stroke Foundation and CHEP executive member.
    As many as 175,000 Canadians with high blood pressure may be currently
treated with this combination of medications.
    Angiotensin Converting Enzyme (ACE) inhibitors are a type of blood
pressure medication that helps widens blood vessels, making it easier for
blood to flow through. Angiotensin II Receptor Blockers (ARBs) inhibit the
action of a peptide called angiotensin, which causes blood vessels to narrow,
helping to relax the blood vessels and lower blood pressure.
    According to CHEP, most people who develop hypertension will require
treatment with two or more medications plus lifestyle modifications. Treating
these patients with combinations of drugs will remain a widespread and highly
effective practice.
    But problems surfaced earlier this year in the ONTARGET study carried out
by Heart and Stroke Foundation researchers and published in the New England
Journal of Medicine.
    In this major international clinical trial of 25,620 patients, the drug
combination of an ACE inhibitor and an ARB was found to be only marginally
more effective at lowering blood pressure than either of the drugs taken
alone. In addition, patients on this combination experienced more side effects
such as kidney problems than those on only one of the drugs. Patients were age
55 and over and had vascular disease or high-risk diabetes.
    "This trial is a landmark study that helps healthcare providers better
understand and more safely prescribe drug combinations for hypertension," says
Margaret Moy Lum-Kwong, director of the High Blood Pressure AIM Strategy of
the Heart and Stroke Foundation of Ontario. "If you are on this particular
combination treatment for high blood pressure do not stop taking your
medication. Instead go directly to your doctor for an alternative treatment."
    "There is a synergy that happens when you use this particular drug
combination but, unfortunately, it is not a synergy that benefits patients,"
says Dr. Tobe who is also a nephrologist at Sunnybrook Health Sciences Centre
in Toronto. "When you put the two drugs together, you don't get any additional
protection against heart attacks and strokes and you get more negative side
effects."
    ACE inhibitors and ARBs both lower blood pressure through their action on
the renin-angiotensin system - a group of hormones regulated by the kidneys
that control long-term blood pressure. "The combined action of these two drugs
is a source of major stress on the kidneys," says Dr. Tobe.
    "They don't give any additional benefit in combination but each is
associated with side effects so all you do is double up the side effects but
you don't double up the benefits."
    Side effects can include fainting, diarrhea, and dangerously elevated
potassium levels which could result in the need for dialysis - or death.
    Margaret Moy Lum-Kwong has some advice for Canadians with high blood
pressure: "Be aware of your medications - know what you are taking and why.
    "Sometimes more is not better," says Dr. Tobe. "The good news is that
patients who are experiencing side effects recover as soon as they get off the
combination of medications," he says. The recommendations also describe how to
combine blood pressure medications appropriately to lower blood pressure in
people with diabetes.
    The Heart and Stroke Foundation and CHEP have translated the professional
blood pressure management guidelines and they are available at
www.heartandstroke.ca. For more information on hypertension medications go to
www.hypertension.ca.

    The Heart and Stroke Foundation's Blood Pressure Action Plan(TM) offers
realistic strategies and on-going support to help individuals prevent and
control high blood pressure. Canadians can get a free, confidential risk
assessment by going to www.heartandstroke.ca. To find out more about Heart and
Stroke Foundation lifestyle or stroke and heart disease information, and to
learn how you can offer much-needed support in your community call
1-888-HSF-INFO (1-888-473-4636).

    
    B-roll will be available through CNW Group - at the listed times and
    co-ordinates:

    Live Satellite Coordinates:

    DATE OF FEED:   Friday, January 16/09
    TIME OF FEED:   2:00PM ET
    COORDINATES:    Anik F2 C
                    Transponder 3B
                    Audio subcarrier 6.2 and 6.8
                    Downlink frequency 3820 vertical
    





For further information:

For further information: Stacy O'Rourke, Heart and Stroke Foundation,
(416) 937-5307

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Heart and Stroke Foundation of Ontario

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