Antihypertensive meds lower blood pressure, don't fix all vessel damage

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Antihypertensive treatments might be effective in lowering blood pressure, but they don’t fully reverse the damage done to blood vessels and microcirculation after years of living with hypertension, a group of scientists at Lancaster University have reported in Frontiers in Physiology.

Professor and study author Aneta Stefanovska and colleagues in the United Kingdom analyzed three groups—one cohort of younger patients in their twenties and two groups of over-70 seniors—and their bodies’ reactions to antihypertensive medications. Since the World Health Organization estimates 40 percent of the total global population over the age of 25 develops hypertension, Stefanovska and her team sought to evaluate the efficacy of blood pressure-lowering drugs.

Hypertension is a major risk factor for heart disease, stroke and kidney failure, Stefanovska and co-authors wrote in the study, and can lead to premature death and disability.

“Currently available treatments that successfully reduce blood pressure also claim to revert the associated microvascular dysfunctions such as rarefaction and loss of reactivity,” the authors wrote.

When studying the older patients, who were split into two groups based on whether or not they were taking medication for high blood pressure, the researchers noticed some gaps. While antihypertensive drugs seemed to restore normal function in the hypertensive cohort’s arterioles and larger vessels, Stefanovska and colleagues noticed the same functionality wasn’t present in the patients’ smaller vessels.

According to the study, hypertensive treatments failed to restore normal vascular rhythms in smaller vessels. The strength of coupling between vascular rhythms, respiration and oscillation in heart rate were compromised, Stefanovska said in a release from Lancaster University, and while these connections do weaken as people age, they’re still important for a well-functioning cardiovascular system. Current antihypertensive drugs aren’t able to compensate for the dysfunction caused by high blood pressure.

Stefanovska said her study could be helpful in future drug development projects.

“It is clear that current antihypertensive treatments, while successfully controlling blood pressure, do not restore microvascular function,” she said. “The results have not only confirmed previous observations of progressive impairment with age of the underlying mechanisms of coordination between cardiac and microvascular activity, but for the first time have revealed that these effects are exacerbated in hypertension.”