Researchers at Queen Mary University of London and Barts Health NHS Trust have effectively managed blood pressure control in patients who have developed tolerance towards antihypertensive medication. The scientists used medicines in non-traditional ways and used a ‘stepped care’ approach to treat the patients, which involves administering the most efficient yet least intensive treatment first.

Issue Of Uncontrolled Blood Pressure

Around 15 million people in the UK are hypertensive, of which half of them quit their antihypertensive medication within 12 months of prescription. This results in severe drug tolerance and is common in about 10 percent of hypertensive patients. The tolerance also increases the risk of kidney failure, stroke and heart attack as a result of uncontrolled blood pressure, and finding alternative treatment strategies has become vital.

Another aspect is the severe side effects of antihypertensive medications. These can be debilitating and significantly compromise quality of life. With alternative treatment options, patients could be saved from such suffering.

Lead researcher Dr Melvin Lobo from Queen Mary University of London is also Director of the Barts Health Blood Pressure Clinic.

According to him, changing the way we use existing medication, and focusing on a more personalized approach rather than an ‘off the shelf’ regime could allow patients to tolerate more medicines and ultimately have long-lasting effects on lowering blood pressure.

Study: Finding Alternative Treatment Strategy

Published in the Journal of Clinical Hypertension and supported by Barts Charity, the study devised a new treatment regime for 55 patients, including fractional dosing (taking half or a quarter) with tablets, liquid formulations of antihypertensive medication, and patch formulations of drugs. The researchers also used unlicensed drugs in the process.

Results showed a significant and sustained decrease in blood pressure just after six months of the treatment regime. Moreover, no debilitating side effects were experienced.

Many patients report of having negative experiences with doctors when they complain about experiencing drug side effects. It is a general belief that reducing the health risks of hypertensive patients, including stroke or a heart attack, justifies the extremely serious drug intolerance that they might experience.

“We, however, took a different approach. We understand that certain patients feel compelled to stop treatment due to miserable it makes them feel. Hence, we set out to try and help them get around the side effects instead of forcing them to take their medication despite them feeling as if they were being poisoned and willing to try suicide instead,” commented Dr Lobo.

Implementing Approach: A New Way To Manage Blood Pressure

The researchers urge clinicians to adopt a more sympathetic attitude with patients reporting adverse side effects to medication. Patients should not be scolded or blamed for experiencing these symptoms, since it is the drugs and not the disease that makes them symptomatic. Dr Lobo is also planning to extend the study into primary care in a hope of widening and broadening the impact of the team’s findings.