High blood pressure, or hypertension, is a major risk factor for heart disease, the leading cause of death in the United States. But a new study has found that two classes of medication that are commonly used to lower blood pressure could present a death risk all on their own.
Scientists at the Intermountain Medical Center Heart Institute in Salt Lake City, UT, found that individuals with hypertension who used alpha blockers and alpha-2 agonists to control their blood pressure showed an increase in blood pressure variability, which could increase mortality risk.
Blood pressure is the force of blood that pushes against the wall of the arteries. And, in November last year, the American Heart Association (AHA) and the ACC set new guidelines.
Now, a person is considered to have hypertension if their systolic blood pressure (the top number) is 130 millimeters of mercury (mmHg) or higher, and their diastolic blood pressure (the bottom number) is 80 mmHg or higher.
Systolic blood pressure is the force of blood against the artery walls when the heart is beating, while diastolic blood pressure is the force of blood when the heart is at rest, or between heartbeats.
The updated guidelines mean that almost half of adults in the United States have high blood pressure, which puts them at greater risk of heart attack, stroke, and heart disease, among other health problems.
Of course, when it comes to treating hypertension, the goal is to lower blood pressure. This may be achieved through lifestyle changes — such as adopting a healthful diet and increasing physical activity — medication, or both.
According to the new study from Dr. Clements and colleagues, certain types of medication that are used to lower blood pressure may be contributing to this mortality risk.
The study revealed two classes of blood pressure medication that were linked to higher blood pressure variability in subjects: alpha blockers and alpha-2 agonists.
Alpha blockers — which include doxazosin mesylate and prazosin hydrochloride — work by dilating the blood vessels. Alpha-2 agonists, such as methyldopa, work by targeting sympathetic nervous system activity, thereby reducing blood vessel constriction.
Based on the study results, Dr. Clements and colleagues say that these two medications should not be used to treat hypertension.
“Patients should know what their blood pressure is,” he says, “and if it’s up and down all the time, the patient should work with their physician to explore options for the best blood pressure medications that will reduce variances.”
Dr. Clements adds that ace inhibitors, angiotensin receptor blockers, calcium channel blockers, and thiazide diuretics may be safer treatment options for people with hypertension. “People who are on other types of blood pressure medications have an increased risk of death,” he adds.