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There was also a small but statistically significant increase in heart rate among patients treated with the highest dose of phentermine/topiramate, but overall reductions in systolic and diastolic blood pressure led to an improvement in rate pulse pressure, according to investigators.
The implication, says one expert, is that physicians can't be complacent with a normal blood pressure in African Americans measured inside the office. The cardiovascular risk factors associated with masked hypertension are equal to that of individuals with sustained hypertension.
Speaking with the media during a press conference announcing the results, the lead investigator said chlorthalidone was selected as the second agent with azilsartan and partnered in development because there is growing evidence the drug is more effective than HCTZ. The purpose of the study was to compare the effectiveness of the azilsartan/chlorthalidone combination with the maximum approved dose of olmesartan/HCTZ, that being 40/25 mg.
While investigators are not yet recommending relocating large swaths of the hypertensive population to space, data showing zero gravity lowers blood pressure, as well as a not-yet-understood increase in catecholamine levels, open up the possibility that unknown mechanisms might be involved in blood-pressure regulation.
A number of studies presented this week are addressing improvements in hypertension control. One project, from a group in Northern California, showed that by adhering closely to clinical guidelines, developing a hypertension registry, and disseminating best practices from high-performing centers to other groups, hypertension control rates could be boosted from 44% to 80%.
The researchers noted that 30% of firefighters had elevated blood-pressure levels, and of those who had normal blood pressure, 13% had an excessive systolic and diastolic blood-pressure response to an exercise stress test. This adrenergic response might also occur while fighting fires and could partially explain why this high-risk occupation has a higher risk of coronary heart disease.
