HYPERTENSION WATCH

Pharmacy Times, Volume 0, 0

Possible Link Between Hypertension and Dementia Found

A recent study suggests that there may be a potential link tothe presence of high blood pressure in middle age and the developmentof dementia in old age. Some physicians are hesitant totreat hypertension in the elderly because of concerns about loweringthe patients'cognitive functioning. Clinical trials show,however, that not only is there no harm in hypertension treatment,but it also may actually benefit them mentally. The resultswere reported in the April 6 on-line version of Stroke: Journal ofthe American Heart Association.

The study analyzed data on 1294 men who were taking partin a long-term study on aging. About two thirds of these menhad hypertension in their middle-age years, and none haddementia at approximately age 77. Six years later, 108 of thesemen were diagnosed with signs of dementia, mostly Alzheimer's.The results of the study showed, however, that thelonger the men were taking medicine to treat their hypertension,the less likely they were to develop dementia. Treatmentof <5 years correlated to a 6% lower dementia risk, 5 to 12 yearsof treatment related to a 48% lower risk, and those treated for>12 years reduced their risk by 60%.

Study Shows Hypertension Drug Reverses Cell Death

Researchers at Purdue Universityhave found that a medicine commonlyused to treat high blood pressuremay also reverse damage tocells caused by spinal cord injuries,cancer, and Parkinson's disease. Theyfound that hydralazine, a drug usedto relax the veins and arteries, maybe an antidote for acrolein, a deadlytoxin that is made after a nerve cell isinjured. The findings were publishedin the Journal of Neuroscience (April17, 2006).

Acrolein can remain in the body fordays and is responsible for secondarydamage that keeps damaged cellsfrom healing on their own. It is a typeof cell toxin called an aldehyde;hydralazine works by trapping aldehydes,neutralizing, deactivating, andsecreting them. The researchers collecteddata on acrolein from cell culturesand found that the toxin candestroy entire cell groups in <12hours. They also learned that morethan 80% of these cells would surviveif the toxin were treated withhydralazine. Researchers hope that ifhydralazine is introduced earlyenough after initial cell damage, itmay slow down the processes of diseasessuch as Alzheimer's andParkinson's.

Lonely Seniors Risk Elevated BP

Researchers have found that loneliness can have a physical as well as emotionaleffect on people, elderly patients in particular. Lonely people have higherblood pressure (BP) readings than nonlonely people, even when depressionand stress are taken into account. Differences in BP between lonely and nonlonelypeople were shortest at age 50 and grew as the ages increased, up to68 years. The findings of the study from the University of Chicago were publishedin the journal Psychology and Aging.

The researchers studied 229 older adults and asked them a series of questionsto determine if they perceived themselves as lonely. The team alsoexamined data on weight, alcohol consumption, smoking, BP medications, anddemographic characteristics. Researchers theorize that "lonely people differfrom nonlonely [people] in their tendency to perceive stressful circumstancesas threatening rather than challenging, and to passively cope with stress byfailing to solicit?support, and by withdrawing from stress rather than?coping."The National Institute on Aging is looking at these findings to help determinewhat can be done for this population to improve relationships and helpalleviate both loneliness and hypertension.

Stress on the Job May Not Raise BP

Contrary to popular belief, a newstudy shows that there may not be acorrelation between job stress and elevatedblood pressure (BP). A review of48 studies on job stress and BP showedno relationship between the two, andthose studies that did seem to find arelationship were weak and inconsistent.Although there was no doubt thatbrief confrontations on the job can raiseBP for a short time, the relationshipbetween recurring work stress andchronic hypertension has yet to be confirmed.The results of the review werepublished in the May 2006 issue ofCurrent Hypertension Reviews.

Study authors reviewed data fromstudies published in English-languagejournals from 1982 to 2004. The studiesincluded >100,000 people. Out of the 48studies included, only 20 found any relationshipbetween job stress and BP.Additionally, the researchers stated thatonly 26 of the studies looked at the relationshipof job stress and BP over time,using ambulatory BP measurements,which are considered to be more precisebecause the measurements moreaccurately reflect BP in a person's naturalenvironment. Of these studies, only10 showed a positive relationshipbetween job stress and systolic BP (considereda more reliable indicator of heartdisease risk than diastolic BP).