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| |  Preliminary Study Shows Allopurinol Lowers Blood Pressure in Adolescents With Hypertension CHICAGO -- August 26, 2008 -- Allopurinol appears to reduce blood pressure in adolescents with newly diagnosed hypertension, according to a preliminary report published in the August 27 issue of the Journal of the American Medical Association. Previous research has suggested that uric acid has a causal role in hypertension, but an elevation of uric acid in hypertension could be a consequence of several factors. Daniel I. Feig, MD, Baylor College of Medicine, Houston, Texas, and colleagues conducted a randomised, placebo-controlled, crossover trial to determine whether lowering uric acid levels with allopurinol would reduce blood pressure (BP) in hyperuricaemic adolescents, aged 11 to 17 years, with newly diagnosed hypertension. Patients (n = 30) were randomly assigned to receive either allopurinol or placebo, twice daily for 4 weeks. This was followed by a 2-week washout period during which the patients received neither allopurinol nor placebo, after which they received the therapy they had not received earlier, for 4 more weeks. Allopurinol treatment was associated with a significant decrease in casual and ambulatory systolic and diastolic BP. The average decrease in casual BP during allopurinol treatment was -6.9 mm Hg for systolic and -5.1 mm Hg for diastolic BP. For placebo, the changes were -2.0 mm Hg for systolic and -2.4 mm Hg for diastolic. The average changes in 24-hour ambulatory BP during allopurinol were -6.3 mm Hg, systolic; -4.6 mm Hg, diastolic BP. Systolic BP increased slightly during the placebo phase by 0.8 mm Hg and diastolic BP slightly decreased by 0.3 mm Hg. The decrease in ambulatory BP directly correlated with allopurinol treatment. Twenty of the 30 participants achieved normal BP by casual and ambulatory criteria during the allopurinol phase, whereas only 1 of 30 achieved normal BP during the placebo phase. "The results of this study represent a potentially new therapeutic approach, that of control of a biochemical cause of hypertension, rather than nonspecifically lowering elevated BP. Although not representing a fully developed therapeutic strategy, this study raises an alternative strategy that may prove to be more effective than currently available options," the authors wrote. "Despite these findings, this clinical trial is a small one and … the potential adverse effects of allopurinol, including gastrointestinal complaints and especially Stevens-Johnson syndrome, make allopurinol an unattractive alternative to available antihypertensive medications." More clinical trials are needed to determine the reproducibility of the data and whether it can be generalised to the larger hypertensive population. SOURCE: Journal of the American Medical Association
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