Pharmacy Times

HYPERTENSION WATCH


Acupuncture Ineffective for Hypertension

According to a new report from the New England Research Institutes in Watertown, Mass, standardized or individualized traditional Chinese acupuncture is no better than a fake procedure in reducing blood pressure (BP) in patients with hypertension. The findings from small clinical trials, as well as studies of individual cases, have suggested a possible benefit of acupuncture in patients with high BP in the past. It was only recently, however, that a larger trial has been reported.

The Stop Hypertension with the Acupuncture Research Program enrolled 192 patients with untreated hypertension (average BP 149/93 mm Hg). The researchers randomly assigned the participants to undergo either standardized acupuncture, individualized acupuncture, or sham acupuncture. The patients attended up to 12 sessions over the course of 6 to 8 weeks, and their BP readings were noted every 2 weeks for 10 weeks. When all subgroups—age, race, gender, baseline BP, etc—were taken into account, the researchers were unable to find a significant benefit in any of the 3 groups. (The findings were published in the November 2006 issue of Hypertension.)

Factors Behind Hypertension in Obese Children

Scientists at the University of Chieti in Italy have learned that adiposity and insulin resistance (IR) could explain why obese children are 3 times more likely to be hypertensive, compared with their leaner counterparts. In the past, few studies examined whether there was a link between adiposity and the presence of IR and high blood pressure (BP) in children. The scientists measured ambulatory BP parameters, body mass index, and fat mass in 56 obese prepubertal children.

In line with past information on adults, BP parameters were significantly related to both adiposity and IR in the children. After controlling for obesity, only the relationship between diastolic BP and IR remained relevant.

The researchers pointed out that this could "possibly indicate a dominant role of IR in influencing diastolic instead of systolic BP values." There was no notable relationship between waist-to-hip ratios and BP parameters, but the researchers noted that was because of a high percentage of the children in the study having similar elevated ratios. It was also noted that 42% of the children experienced "nondipping phenomena," a risk factor for organ damage in adults. Generally BP levels tend to be lower in the morning, higher during the day, and lower at night. Those experiencing the phenomena have consistently high BP. The study's results were published in the Journal of Hypertension (December 2006).

Parents: Reduce Kids' Salt Intake

The findings of a metaanalysis indicated that even minor reductions in salt intake in children could lessen age-related blood pressure (BP) increases, which could correlate to a reduction in the risk of future cardiovascular diseases. The researchers stated that current salt intake is unnecessarily high in children, and that could predispose them to hypertension.

The researchers carried out a meta-analysis of 10 trials that included a total of 966 children and adolescents aged 8-16 which studied the effects of reducing salt intake. Overall, the children's intake of salt was lowered by 42%, which led to a significant reduction in both systolic (by an average of 1.17 mm Hg) and diastolic (1.29 mm Hg) BP. A separate analysis of 3 other trials showed that a 54% reduction in salt intake was associated with a 2.47-mm Hg drop in systolic BP in infants.

The researchers concluded that "a modest reduction in salt intake causes immediate falls in BP and, if continued, may well lessen the subsequent rise in BP with age." The findings were published in the November 2006 issue of Hypertension.

Hypertension More Likely in Teen Boys

A Canadian research team has found that adolescent boys are at a greater risk of having high systolic blood pressure (BP) than girls. Their study looked at about 1300 Montreal teenagers between grades 7 and 11, and they saw that for teen girls, the risk for elevated systolic BP remained stable for their average age and height during the time frame, while the risk for boys increased. When the study started in 1999, the numbers of boys and girls with normal BP were almost the same, according to lead investigator Kaberi Dasgupta, MD, an internist at McGill University.

By the time the children reached age 15, however, boys were twice as likely as girls to have a BP reading in the top range for their age and height. By the time they reached age 17, boys were 2.5 times as likely as the girls to have an elevated BP, and more than two thirds of all children with high BP were boys. The researchers found a link between being overweight and a 2-to 3-fold risk of having high BP among both sexes, and the more sedentary the teens were, the greater the risk of hypertension. The findings were published in the December 2006 issue of Circulation.