Published in 11/2022 – Released June 14, 2022
Bolzano/Vinschgau – Many older people swallow one or more blood pressure tablets with their morning coffee. But the pills don’t always work. The data from the CHRIS study, the population study by Eurac Research and the South Tyrolean medical company, now form a valuable basis for investigating why high blood pressure therapies do not work in some people. For example, the research team working on the HyperProfile study is using biomarkers to measure the effectiveness of certain drugs on one of the biological processes that control high blood pressure. The biologist Luisa Foco from the Institute of Biomedicine of Eurac Research is the responsible researcher.
the Vinschger: Does it often happen that therapies against high blood pressure do not work?
Louise Focus: Of the people who participated in the first phase of the CHRIS study, 1,814 were already being treated for high blood pressure. However, in about half of the cases, the blood pressure was not under control. In some cases, drug therapy can be adjusted even better, in other cases we can speak of real resistance. High blood pressure is often due to a lack of discipline when taking medication and a wrong lifestyle, but there is also a not inconsiderable proportion of people for whom high blood pressure medication does not work.
What are the most commonly used drugs?
One of the most common combinations currently used for high blood pressure is a combination of three: an ACE inhibitor or sartans, a diuretic, and a calcium channel blocker. About 30 percent of the CHRIS participants with high blood pressure take ACE inhibitors or sartans and another 18.5 percent also take a diuretic. 154 people were prescribed the currently most commonly used combination. We’re talking about people who take at least three pills a day – and despite everything, 87 of them, more than 56 percent, still have high blood pressure.
Why is this?
To understand why drugs cannot regulate blood pressure, the first step is to examine what happens at the molecular level in people who do not respond to therapy. How blood pressure is controlled is like watching a movie in which countless actors take part, with what is known as the “renin-angiotensin-aldosterone system” (RAAS for short) playing the leading role. The main antihypertensive drugs work precisely on this system.
How does the data from the CHRIS study contribute to this research?
For each CHRIS participant profile, we examine six biomarkers that indicate how this RAAS process works. It has been confirmed that drugs work, but also that they are not always effective. For example, there are people who have much higher adrenal activity than one would expect because they take medications that inhibit the production of a hormone called aldosterone. This could indicate that the high blood pressure is the result of another disease, namely primary aldosteronism. In this case, blood pressure could be controlled simply by changing medications. In general, the markers we study can help the doctor choose the best therapy.
The Study
Research partners include the Eurac Research Institute for Biomedicine, the University of Glasgow, the French research institute Inserm and the Schlanders Hospital. In particular, Dr. Stefano Barolo, head of the Outpatient Department for Arterial Hypertension and Cardiovascular Risks, the study and warns: “In Italy, one in three people suffers from what is known as hypertension. This number will increase in the future due to the aging population. Because with age, the elasticity of the artery walls decreases, which leads to an increase in systolic blood pressure. Angiotensin-Aldosterone System.