Researchers at the University of Glasgow are looking to recruit GP Practices to take part in a study of treatment methods for people with resistant hypertension.

The aim of the study is to find effective ways of treating the 20 per cent of patients whose high blood pressure does not respond to the usual first-line drugs prescribed by doctors.

Professor Gordon McInnes, Professor of Clinical Pharmacology in the Department of Cardiovascular and Medical Sciences, who is heading the study at the University of Glasgow, said: “High blood pressure is directly responsible for around seven millions deaths a year worldwide, more than anything else; therefore managing high blood pressure is hugely important.”

GPs in the UK currently treat patients with hypertension by following a pathway called the ACD algorithm which involves prescribing drugs in a logical fashion.

If one drug alone proves ineffectual in controlling blood pressure, another drug is given in tandem.

A third drug  can be added to the mix if blood pressure is still not being adequately controlled, but for 20 per cent of patients even three drugs still fails to treat their hypertension effectively.

In such an event doctors then have to go through a process of trial-and-error with a succession of different drugs such as alpha or beta blockers, renin inhibitors or further diuretics, but some of these can increase the risk of patients developing type-2 diabetes.
The study will examine this current process asking whether treatment should commence with two drugs, rather than prescribing only one initially; how patients with hypertension resistant to normal treatment can be best managed; and whether using different diuretic medication reduces the risk of developing diabetes?
 
Researchers will study how patients with resistant hypertension respond to three different drugs commonly used in this group – spironolactone, atenelol, and doxazosin – and why they respond the way they do.

Prof McInnes added: “Different people respond to different drugs for different reasons. We want to find out what the common factors are in particular patients who respond to particular drugs so we can provide them with the most suitable treatment thereby giving doctors a much better idea of which drugs to use in patients whose hypertension is resistant to the initial treatment.

“Ultimately, the idea is to extend the ACD algorithm currently used in treating hypertension to ensure the condition is effectively managed in all patients.”

It is hoped the study, entitled PATHWAY which is being led by the University of Cambridge, will recruit 1,440 patients across eight sites: Imperial College London, St Bartholomew’s Hospital, London; and the Universities of Glasgow, Edinburgh, Dundee, Manchester, Cambridge and Leicester.

GP practices interested in taking part in the study should contact Professor Gordon McInnes (gordon.t.mcinnes@clinmed.gla.ac.uk or 0141 211 2319) or Research Nurse Donald Fraser (Donald.fraser@ggc.scot.nhs.uk or 0141 232 9515).

For more information contact Stuart Forsyth in the University of Glasgow Media Relations Office on 0141 330 4831 or email s.forsyth@admin.gla.ac.uk

First published: 28 January 2010

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