Hypertension is a chronic debilitating disease with huge socioeconomic and psychological impacts. Despite billions of dollars invested in the development of traditional pharmacotherapy for the management of hypertension, the incidence of this disease is on the rise and has escalated to worrying proportions.
This has led many to conclude that traditional pharmacotherapy has reached a plateau, and novel approaches for the treatment and control of hypertension must be explored.
Prevalence in Malaysia and Singapore
In Malaysia overall, there is a rising trend in the prevalence of hypertension in adults above 30 years. The prevalence peaked at 74.1% among population aged 65 to 69 years in the 2011 National Health and Morbidity Survey. Prevalence of hypertension increased markedly from age 40 onwards and similarly to Malaysia, more than half (53.4%) of the elderly aged 60 to 69 years had hypertension.
Meanwhile in Singapore, the hypertensive rates of adults declined from 24.9% in 2004 to 23.5% in 2010. These findings suggest that the magnitude of hypertension in both countries need additional attention leading to the recent discovery of genetic associations and possible new treatments to be of immense value.
New drug reduce nervous system activity to regulate BP
Julian Paton, professor of physiology at the University of Bristol who led the study said, "We discovered that these tiny organs become hyperactive in conditions of hypertension, generating what we have called aberrant or tonic discharge, which is sent into the brain regions controlling cardiovascular activity.”
“In this way, changes within the carotid body may be a cause of high blood pressure and therefore represent a novel target for controlling blood pressure," she added. The aim is for this drug to normalise its activity levels to a more regular blood pressure range.
This novel approach marks the first anti-hypertensive treatment strategy in more than a decade to be directed at a root cause of excessive sympathetic discharge to cardiovascular end-organs.
New genes and genome tied to blood pressure control
In a separate work, a prominent group of researchers including the investigators from Brigham and Women's Hospital (BWH) identified approximately 60 loci known to be associated with blood pressure. Their data were derived from more than 146,000 individuals of European, African, and Hispanic descent revealed biological pathways, including those related to immunologic diseases, diabetes, kidney function and thus establishing new connections between blood pressure and other clinical conditions.
These findings open up many doors for potential treatment of one condition which could potentially mange many other related conditions. Together, these papers have introduced double the number of known loci for this chronic condition. These studies will serve to help in detecting new methods to better manage this important risk factor which leads to heart attacks and strokes, two major causes of mortality in all nations.
By targeting the nerve signals in the carotid bodies, which encompass the chemoreceptors responsible for detecting and regulating change in partial pressure within arterial vessels, the researchers may have identified new territory in the treatment of hypertension.
With the myriad range of drugs available in the market targeted at hypertensive care, this new angle involves a more localised approach by reducing the nervous system’s activity in the carotid body which is known to cause blood pressure elevations.
This may provide a means for the permanent control and possible cure of hypertension as current therapies target only a small subset of the pathways contributing to hypertension.
Thus, identifying the additional genes that influence blood pressure in hand with targeting the root cause of sympathetic activity can potentially steer us in new directions In combining the findings of both researches hence creating a synergy of the best of both worlds introduces exciting new trends for drug development. MIMS
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